Pantoprazole Viatris (Pantoprazole Sodium Sesquihydrate)

Pantoprazole is a proton pump inhibitor that decreases stomach acid production, addressing several acid‑related disorders.

• Gastro‑oesophageal reflux disease (GERD): alleviates heartburn and promotes healing of the oesophageal lining.
• Erosive oesophagitis: facilitates mucosal repair and reduces symptom recurrence.
• Zollinger‑Ellison syndrome: controls excessive gastric acid secretion associated with gastrin‑producing tumours.
• NSAID‑induced gastric ulcer: aids ulcer healing and prevents recurrence.
• Helicobacter pylori eradication (as part of combination therapy): enhances bacterial clearance when used with antibiotics.

• Pantoprazole selectively and irreversibly inhibits the H+/K+‑ATPase enzyme (the gastric proton pump) located on the secretory surface of parietal cells, thereby blocking the final step of acid production and leading to sustained reduction of gastric acidity.

Pantoprazole is generally well tolerated, but adverse reactions can occur.

Common Side Effects

• Headache: mild to moderate intensity.
• Diarrhoea: loose stools, usually transient.
• Nausea: occasional upset stomach.
• Abdominal pain: cramping or discomfort.
• Flatulence: increased gas.
• Constipation: reduced bowel movements.

Serious or Rare Side Effects

• Clostridioides difficile infection: severe colitis risk.
• Severe allergic reactions: rash, swelling, anaphylaxis.
• Hypomagnesemia: low magnesium levels with prolonged use.
• Vitamin B12 deficiency: potential long‑term deficiency.
• Liver enzyme elevation: signs of hepatic stress.
• Bone fractures: increased risk with long‑term therapy.

Before initiating therapy, consider the following safety measures.

• Renal function assessment: adjust use in severe impairment.
• Magnesium monitoring: check levels during prolonged treatment.
• H. pylori testing: confirm infection status when indicated.
• Elderly patients: use caution due to higher fracture risk.
• Long‑term use evaluation: reassess necessity periodically.
• Store at room temperature: keep in the original pack, protect from moisture.

Pantoprazole may affect the plasma concentrations of several co‑administered drugs.

Major Interactions (Avoid)

• Clarithromycin: increased pantoprazole levels.
• Ketoconazole: reduced antifungal absorption.
• Atazanavir: markedly decreased antiviral exposure.
• HIV protease inhibitors (e.g., ritonavir): diminished efficacy.
• Clopidogrel: reduced antiplatelet effect.

Moderate Interactions (Monitor Closely)

• Digoxin: possible increased serum concentration.
• Methotrexate: reduced renal clearance, risk of toxicity.
• Warfarin: potential alteration of INR.
• Phenytoin: decreased antiepileptic levels.
• Diazepam: enhanced sedation risk.