Pantoprazole alternatives: Other PPIs and lifestyle changes

In this article:

• What can I take instead of pantoprazole?
• Compare Protonix (pantoprazole) alternatives
• Top 5 pantoprazole alternatives
• Natural alternatives to pantoprazole
• How to switch to a pantoprazole alternative

In this article

• What can I take instead of pantoprazole?
• Compare Protonix (pantoprazole) alternatives
• Top 5 pantoprazole alternatives
• Natural alternatives to pantoprazole
• How to switch to a pantoprazole alternative

Pantoprazole is a generic prescription medication used to treat gastroesophageal reflux disease (GERD), erosive esophagitis, and other conditions related to excess stomach acid, such as peptic ulcers. It belongs to a class of drugs called proton pump inhibitors (PPIs), which reduce stomach acid production by blocking the microscopic pump on the acid producing cells in the stomach. The brand-name version of pantoprazole is Protonix.

Pantoprazole may not be right for everyone because of side effects, cost, or how well it works. Alternatives include other PPIs, some of which are available over the counter, as well as another type of acid reducer called H2 blockers.

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Related: What’s the best heartburn medicine for you?

What can I take instead of pantoprazole?

There are other options available to treat GERD or other stomach acid-related conditions that do not improve with pantoprazole. Other PPIs generally provide similar acid suppression when used at equivalent doses, so factors such as cost, dosing, and individual response may help determine which PPI is most suitable. Other alternatives include histamine H2 antagonists (H2 blockers) and antacids. These options have different uses, side effects, dosages, and costs that may make them more suitable for certain people.

Top 5 pantoprazole alternatives

The following are some of the most common alternatives to pantoprazole.

1. Omeprazole (Prilosec)

Omeprazole is one of the most commonly used PPIs and works similarly to pantoprazole by reducing stomach acid production by blocking acid-producing cells. Unlike pantoprazole, prescription omeprazole is FDA approved to treat stomach and duodenal ulcers and, when used with certain antibiotics, to treat H. pylori infection in adults with peptic ulcer disease.

Omeprazole is available both by prescription and over the counter. Prescription omeprazole delayed-release capsules come in 10 mg, 20 mg, and 40 mg strengths, while OTC Prilosec contains 20 mg of omeprazole. For people who have difficulty swallowing capsules, prescription omeprazole capsules can be opened and mixed with one tablespoon of applesauce. Prescription omeprazole should be taken 30 to 60 minutes before meals.

Omeprazole has similar common side effects as pantoprazole, including nausea, diarrhea, vomiting, abdominal pain, headache, and flatulence. Because pantoprazole is only available by prescription, omeprazole may be a suitable alternative for people looking for an OTC treatment option.

Related: Pantoprazole vs. omeprazole

2. Esomeprazole (Nexium)

Esomeprazole is another PPI that works similarly to pantoprazole by reducing stomach acid. Also available under the brand name Nexium, esomeprazole comes in both prescription and over-the-counter (OTC) forms. For people who have difficulty swallowing capsules, prescription esomeprazole capsules can be opened and mixed with one tablespoon of applesauce. Prescription esomeprazole should be taken about one hour before meals.

Like other PPIs, esomeprazole has similar common side effects, including headache, diarrhea, nausea, abdominal pain, and flatulence. It may be a suitable pantoprazole alternative for people who have not had adequate symptom relief with pantoprazole or who prefer an OTC treatment option.

Related: Nexium side effects and how to avoid them

3. Lansoprazole (Prevacid)

Lansoprazole, also available under the brand name Prevacid, is another PPI that reduces stomach acid. Lansoprazole is available both by prescription and over the counter. It also comes in different dosage forms, including an orally disintegrating tablet (ODT) that dissolves on the tongue.

For people who have difficulty swallowing capsules, lansoprazole capsules can be opened and mixed with one tablespoon of applesauce, cottage cheese, yogurt, or strained pears. The capsule contents can also be mixed with about 60 mL of apple, orange, or tomato juice. Prescription lansoprazole should be taken before meals as with the other PPIs.

Lansoprazole has similar common side effects as other PPIs, including diarrhea, abdominal pain, nausea, and constipation. Its different dosage forms may make it a suitable alternative for people who have difficulty swallowing capsules, while OTC availability may be convenient for people treating frequent heartburn.

Related: How much is lansoprazole without insurance?

4. Dexlansoprazole (Dexilant)

Dexlansoprazole is another PPI alternative that is also available under the brand name Dexilant. Like pantoprazole, dexlansoprazole is available only by prescription. For adults and children who have difficulty swallowing capsules, dexlansoprazole capsules can be opened and mixed with one tablespoon of applesauce. Dexlansoprazole can be taken any time of day without regard to meals, as it is the only PPI with a dual delayed-release mechanism, meaning the medication is released at two different times. This may be a suitable alternative for people who prefer a more flexible dosing schedule.

Related: Dexilant side effects and how to avoid them

5. Rabeprazole (Aciphex)

Rabeprazole is another PPI available under the brand name Aciphex. Like pantoprazole, rabeprazole requires a prescription. For most conditions, rabeprazole tablets can be taken with or without food, although specific instructions depend on the condition being treated. Rabeprazole may be a suitable alternative for people who have not had adequate improvement with pantoprazole.

Natural alternatives to pantoprazole

Lifestyle and dietary changes may help lessen reflux and heartburn symptoms alongside medication. The American College of Gastroenterology recommends or suggests several lifestyle changes for managing GERD.

Recommended lifestyle modifications include:

• Losing weight if overweight or obese
• Quitting smoking
• Elevating the head of the bed for nighttime GERD symptoms
• Sleeping on the left side
• Avoiding excessive exercise that causes straining
• Avoiding meals two to three hours before bedtime
• Staying upright during and after meals

Certain foods and drinks, such as fatty foods, citrus, caffeine, carbonated beverages, spicy foods, and alcohol, may trigger symptoms in some people. However, triggers vary from person to person, so it may be more helpful to identify and avoid foods that worsen individual symptoms rather than eliminate them all.

There is limited evidence that dietary supplements and other nutritional interventions can help manage GERD symptoms. Studies have evaluated ginger, probiotic yogurt, psyllium husk, prickly pear,  olive leaf extract,  supplements containing melatonin, amino acids, and B-group vitamins. However, most of these interventions have been studied in only a small number of studies and participants, so more research is needed.

Related: 12 home remedies for heartburn

How to switch to a pantoprazole alternative

1. Discuss all health conditions with a healthcare provider

Before switching from pantoprazole to an alternative, the prescribing healthcare provider must be aware of all medical conditions. Some alternatives should be used with caution or avoided with certain medical conditions.

2. Do not suddenly stop taking pantoprazole without medical advice

Talk to the prescribing healthcare provider before stopping pantoprazole. People who discontinue long-term PPI treatment may experience temporary rebound acid symptoms. A healthcare provider can determine whether pantoprazole should be stopped abruptly, gradually reduced, or replaced with another treatment.

3. Discuss all prescription and over-the-counter medications with a healthcare provider

Make sure the prescribing healthcare provider knows about all prescription medications, over-the-counter drugs, and supplements before switching. This can help identify possible drug interactions with a pantoprazole alternative.

Related: The best diet for acid reflux: 3 foods to eat and 8 to avoid