Protonix side effects: A detailed guide

Specifically, the Food and Drug Administration (FDA) has approved Protonix for:

• short-term (up to 10 days) treatment of erosive esophagitis (irritation and inflammation of the esophagus) caused by gastroesophageal reflux disease (GERD)
• maintaining healing following treatment for erosive esophagitis
• treating conditions that cause excessive stomach acid secretion, such as Zollinger-Ellison Syndrome

This article describes possible side effects of Protonix. You can explore this overview article to learn more about Protonix, including the drug’s uses, ways to save on cost, and more.

Protonix is a brand-name medication that comes as a tablet or an oral suspension that you swallow and a solution for injection into a vein. It’s available in a generic version called pantoprazole. This article describes possible side effects of Protonix.

More common side effects of Protonix

Protonix may cause mild or serious side effects. Below are some of the more common side effects of this medication.

Commonly reported side effects of Protonix include:

• headache
• diarrhea
• nausea
• abdominal pain
• vomiting

These side effects were reported in studies of Protonix and Protonix IV for injection.

Mild side effects of Protonix

Protonix may cause certain mild side effects. Most often, mild side effects are temporary and can be easily managed. Tell your doctor or pharmacist if you have side effects that don’t go away or become bothersome.

Mild side effects of Protonix that occurred in studies include:

• abdominal pain
• constipation
• headache
• diarrhea
• nausea
• vomiting
• flatulence
• dizziness
• joint or muscle pain
• sun sensitivity
• dry mouth
• mild allergic reaction*

These side effects were reported in studies of Protonix and Protonix IV for injection. Protonix may cause more side effects than those listed above.

* To learn more about this side effect, see the “Side effects of Protonix in detail” section below.

Serious side effects of Protonix

Protonix may cause certain serious side effects. If you have any serious side effects from Protonix, call your doctor right away. But if you think you’re having a medical emergency or your side effects feel life threatening, take immediate action. Call 911 or a local emergency number, or go to the nearest emergency room.

After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. Visit MedWatch’s website if you’d like to notify the FDA about a side effect you’ve had with Protonix.

Serious side effects of Protonix that occurred in studies include:

• diarrhea associated with Clostridioides difficile bacteria
• life threatening skin reactions, including Stevens-Johnson syndrome and toxic epidermal necrolysis
• new or worsening lupus
• low vitamin B12 level, with long-term use
• a certain type of stomach polyps
• hepatitis
• acute interstitial nephritis (sudden inflammation of the kidneys)*
• increased risk of bone fracture*
• low magnesium*
• severe allergic reaction*

These side effects were reported in studies of Protonix and Protonix IV for injection.

* To learn more about this side effect, see the “Side effects of Protonix in detail” section below.

Download the free Optum Perks Discount Card to save up to 80% on some prescription medications.

Side effects of Protonix in children

For children, doctors prescribe Protonix oral tablet or oral suspension for short-term (up to 10 days) treatment of erosive esophagitis (irritation and inflammation of the esophagus) caused by gastroesophageal reflux disease (GERD). The drug is used for this purpose in children ages 5 years and older.

In studies, the following side effects of Protonix oral tablet and oral suspension were more common in children than in adults:

• upper respiratory infection, such as the common cold
• fever
• skin rash

If you’d like to know more about side effects in children taking Protonix, talk with your doctor or pharmacist.

Common questions about side effects of Protonix

Here are answers to some common questions about the side effects of Protonix. If you have other questions, talk with your doctor or pharmacist.

Can Protonix 40 mg cause more side effects than Protonix 20 mg?

Possibly. In general, a higher drug dosage is more likely to cause side effects compared to a lower dosage. So, a 40 milligram (mg) dose of Protonix may increase the risk of certain side effects compared with a 20 mg dose.

For example, using a higher dosage of Protonix may increase the risk of bone fractures, especially if the drug is used long term.

Talk with your doctor or pharmacist if you’d like to learn more about how your Protonix dosage affects your risk of side effects.

Does Protonix cause long-term side effects?

Yes, in some cases Protonix may cause long-term side effects. These can occur if you take the drug for a long time.

Examples of long-term side effects reported with Protonix include:

• low vitamin B12 level, with long-term use
• low magnesium
• a certain type of stomach polyps
• diarrhea associated with Clostridioides difficile bacteria
• increased risk of bone fracture

These side effects were reported in studies of Protonix and Protonix IV for injection.

Talk with your doctor to learn more about these side effects and how to manage them. Ask your doctor for more information about how long these side effects of Protonix may last.

Is Protonix safe for older adults?

Yes, although this doesn’t mean it’s safe for you specifically.

In studies of Protonix and Protonix IV for injection, side effects were similar in older adults (ages 65 years and older) and younger adults.

But older adults are more likely to develop problems with their kidneys or liver. Having a kidney or liver problem may raise your risk of side effects of Protonix.

Older adults are also more likely to take multiple medications. Taking multiple medications raises the risk of interactions with Protonix, which may raise your risk of side effects.

Talk with your doctor or pharmacist if you’d like to know more about whether your age affects your risk of side effects with Protonix.

Side effects of Protonix in detail

Below you’ll find details on some of the side effects of Protonix.

Acute tubulointerstitial nephritis

Since Protonix and Protonix IV for injection were approved, there have been rare reports of acute interstitial nephritis. This is a known side effect of proton pump inhibitor (PPI) drugs, including Protonix, and may be serious.

With this side effect, you have sudden inflammation in certain parts of your kidneys. Without treatment, this can lead to kidney failure.

Symptoms may include:

• nausea and appetite loss
• malaise (generally feeling unwell)
• fever
• skin rash

Ways to manage

If you experience symptoms of acute nephritis, tell your doctor right away. They’ll likely recommend making an appointment to evaluate your kidney health. They’ll also have you stop treatment with Protonix.

Increased risk of bone fracture

Since Protonix and Protonix IV for injection were approved, studies have noted that treatment increases the risk of bone fractures due to osteoporosis. This side effect may be serious. This is a known side effect of PPI drugs, including Protonix.

Symptoms of a bone fracture include:

• bruising and skin discoloration
• inability to put weight on or move the affected area
• pain

Certain factors can increase the risk of bone fractures with Protonix, such as using the drug long-term (more than one year), particularly at a higher dosage.

Ways to manage

If you have concerns about bone fractures, tell your doctor. They can review your bone health and discuss your risk of fracture. If you have or are at risk of osteoporosis, your doctor may suggest using a calcium and vitamin D supplement to help strengthen your bones.

Low level of magnesium in your blood

Since Protonix and Protonix IV for injection were approved, studies have noted that treatment can cause a low level of magnesium in your blood. This is a known side effect of PPI drugs, including Protonix.

In some cases, low magnesium doesn’t cause symptoms. But without treatment, it could lead to serious effects including seizure and heart arrhythmia (irregular heart rate or rhythm).

Over time, low magnesium can cause low blood level of potassium or calcium, which can further increase the risk of serious effects such as heart arrhythmia.

Symptoms of a low blood magnesium level may include:

• nausea and vomiting
• appetite loss
• weakness
• muscle cramps or spasms

Certain factors can increase the risk of low magnesium with Protonix. These include:

• taking a higher dose of Protonix
• taking Protonix for a long time
• taking Protonix with other medications that can lower blood magnesium

Ways to manage

If you experience symptoms of low magnesium, tell your doctor. They’ll likely recommend stopping treatment with Protonix. If a blood test confirms your magnesium level is low, your doctor can also recommend an appropriate way to treat low magnesium, such as a magnesium supplement.

Allergic reaction

For some people, Protonix can cause an allergic reaction.

Symptoms can be mild or serious and may include:

• itchiness
• skin rash
• swelling under the skin, usually affecting eyelids, lips, hands, or feet
• swelling of the mouth, tongue, or throat, which can make it hard to breathe
• flushing (temporary warmth, redness, or deepening of skin color)

There have also been rare reports of life threatening allergic skin reactions, including Stevens-Johnson syndrome and toxic epidermal necrolysis, in people treated with Protonix.

Ways to manage

For mild allergic reaction symptoms, such as a mild rash, call your doctor right away. They may recommend treatments to help manage your symptoms. They’ll also let you know whether you should keep taking the medication.

For severe allergic reaction symptoms, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms require immediate medical care because they can become life threatening. If you’ve had a serious allergic reaction to Protonix, your doctor may recommend taking a different medication instead.

Warnings for Protonix

Below are some factors you may want to discuss with your doctor before taking Protonix.

Warnings

It may not be safe for you to take Protonix if you have specific health conditions. These are sometimes called drug-condition interactions. Other things may also affect whether Protonix is a safe treatment option for you.

Before taking Protonix, tell your doctor about your health and medications you take. Things to consider include:

• low blood level of calcium, magnesium, or potassium
• osteoporosis
• low vitamin B12
• lupus
• kidney condition, such as chronic kidney disease
• liver condition, such as alcohol-related liver disease
• whether you take a medication that contains rilpivirine, which is found in some medications for treating HIV
• past allergic reaction to Protonix

Protonix and pregnancy

It’s not known whether Protonix should be taken during pregnancy. If you’re planning a pregnancy or can become pregnant, talk with your doctor before taking this medication.

Protonix and breastfeeding

In general, Protonix is considered safe to use while breastfeeding. That said, check with your doctor about whether they feel it’s safe for you specifically.

Protonix and alcohol

Protonix is not known to interact with alcohol.

If you drink alcohol, talk with your doctor about whether it’s safe to consume it during your treatment with Protonix.

What to ask your doctor

This article describes common and serious side effects of Protonix. If your doctor prescribes this medication, they can discuss possible side effects with you. Let your doctor know if you have concerns or questions about treatment with this medication.

Here’s a list of some possible questions you may want to ask your doctor:

• Does Protonix have similar side effects as other proton pump inhibitors such as esomeprazole (Nexium)?
• If I use Protonix short term, am I still at risk of bone fractures?
• Does my health history increase my risk of side effects from taking Protonix?

Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.