{"id":42496,"date":"2021-09-30T17:24:08","date_gmt":"2021-09-30T21:24:08","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=42496"},"modified":"2021-10-06T16:45:53","modified_gmt":"2021-10-06T20:45:53","slug":"protonix-side-effects","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/protonix-side-effects\/","title":{"rendered":"Protonix side effects and how to avoid them"},"content":{"rendered":"<p><span style=\"font-weight: 400;\"><a href=\"#common-side-effects\">Common Protonix side effects<\/a> | <a href=\"#headache\">Headache<\/a> | <a href=\"#diarrhea\">Diarrhea<\/a> | <a href=\"#serious-side-effects\">Serious side effects<\/a> | <a href=\"#infections\">Infections<\/a> | <a href=\"#malabsorption\">Malabsorption<\/a> | <a href=\"#kidney-problems\">Kidney problems<\/a> | <a href=\"#how-long-do-side-effects-last\">How long do side effects last?<\/a> | <a href=\"#warnings\">Warnings<\/a> | <a href=\"#interactions\">Interactions<\/a> | <a href=\"#how-to-avoid-side-effects\">How to avoid side effects<\/a><\/span><\/p>\n<p><a href=\"https:\/\/www.singlecare.com\/prescription\/protonix\"><span style=\"font-weight: 400;\">Protonix<\/span><\/a><span style=\"font-weight: 400;\"> (pantoprazole sodium) is a powerful stomach acid reducer, most renowned for its treatment benefits in <\/span><a href=\"https:\/\/www.singlecare.com\/conditions\/gerd-treatment-and-medications\"><span style=\"font-weight: 400;\">gastroesophageal reflux disease (GERD)<\/span><\/a><span style=\"font-weight: 400;\">, also known as acid reflux. The severity of GERD cases can range from simple heartburn to erosive esophagitis (an ulcerated and inflamed esophagus). Treatment with Protonix is also indicated for hypersecretory conditions of the stomach (excessive acid secretion such as in Zollinger-Ellison Syndrome), H. pylori bacterial infections of the stomach, and upper gastrointestinal bleeding.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The drug falls within the <\/span><a href=\"https:\/\/www.singlecare.com\/drug-classes\/proton-pump-inhibitors\"><span style=\"font-weight: 400;\">proton pump inhibitor (PPI)<\/span><\/a><span style=\"font-weight: 400;\"> class of medications, whose other brand names in this drug class include <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/nexium\"><span style=\"font-weight: 400;\">Nexium<\/span><\/a><span style=\"font-weight: 400;\"> (esomeprazole), <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/prilosec\"><span style=\"font-weight: 400;\">Prilosec<\/span><\/a><span style=\"font-weight: 400;\"> (omeprazole), and <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/prevacid\"><span style=\"font-weight: 400;\">Prevacid<\/span><\/a><span style=\"font-weight: 400;\"> (lansoprazole). Like these other PPIs, Protonix has great utility for the treatment of stomach conditions, but enthusiasm for its use must be tempered by the knowledge of its potential side effects.<\/span><\/p>\n<p><b>RELATED: <\/b><a href=\"https:\/\/www.singlecare.com\/prescription\/protonix\/what-is\"><b>What is Protonix?<\/b><\/a><\/p>\n<h2 id=\"common-side-effects\"><span style=\"font-weight: 400;\">Common side effects of Protonix<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">The following are the most commonly reported Protonix side effects:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Nausea or vomiting<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Diarrhea or constipation<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Stomach pain<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Flatulence (excess gas)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Headache or dizziness<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Arthralgias (joint pains)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Elevated AST or ALT liver enzymes<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Fever, upper respiratory infection, or rash in pediatric patients<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Thrombophlebitis (vein inflammation) with intravenous use<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Vitamin B12 deficiency with long-term use<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Stomach polyps with long-term use<\/span><\/li>\n<\/ul>\n<h3 id=\"headache\"><span style=\"font-weight: 400;\">Headache<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Headache is one of the most commonly experienced adverse effects of Protonix. <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/11876695\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">One study<\/span><\/a> <span style=\"font-weight: 400;\">found 14% of subjects taking pantoprazole had headaches. A persistent, severe, or worsening headache warrants medical attention.<\/span><\/p>\n<h3 id=\"diarrhea\"><span style=\"font-weight: 400;\">Diarrhea<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Another of the more common adverse reactions, diarrhea can be experienced by 4% to 9% of individuals during Protonix therapy. Compared with two other PPIs, lansoprazole and omeprazole, in <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/11012560\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">one study<\/span><\/a><span style=\"font-weight: 400;\">, pantoprazole did not have a higher incidence of diarrhea. When diarrhea becomes severe and watery or accompanied by fever or abdominal pain, a healthcare provider should be consulted. These symptoms could be caused by <\/span><a href=\"https:\/\/www.singlecare.com\/conditions\/clostridium-difficile-treatment-and-medications\"><span style=\"font-weight: 400;\">clostridium difficile (c. diff) infection<\/span><\/a><span style=\"font-weight: 400;\">, a bacterial infection that usually follows an antibiotic course that wipes out the good bacteria in the intestinal tract.<\/span><\/p>\n<h2 id=\"serious-side-effects\"><span style=\"font-weight: 400;\">Serious side effects of Protonix<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Protonix is also associated with some more severe adverse reactions, such as:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">C. diff-associated diarrhea<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Allergic reactions or anaphylaxis<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Severe skin rash or blistering (Stevens-Johnson Syndrome, toxic epidermal necrolysis, and erythema multiforme)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Kidney function impairment or tubulointerstitial nephritis (inflammation within the kidney)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Liver function impairment<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Pancreatitis (pancreas inflammation)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Rhabdomyolysis (muscle damage and breakdown)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Bone fractures<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Systemic lupus erythematosus<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Low sodium levels<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Low magnesium levels with prolonged use<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Abnormal blood cell counts<\/span><\/li>\n<\/ul>\n<h3 id=\"infections\"><span style=\"font-weight: 400;\">Infections<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Certain infections seem to occur more often during PPI therapy. A heightened incidence of <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/16414946\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">C. diff infection<\/span><\/a><span style=\"font-weight: 400;\"> and <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/16414946\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">other intestinal infections<\/span><\/a><span style=\"font-weight: 400;\">, such as <\/span><a href=\"https:\/\/www.singlecare.com\/conditions\/salmonella-treatment-and-medications\"><span style=\"font-weight: 400;\">salmonella<\/span><\/a><span style=\"font-weight: 400;\">, has been noted with PPI use. An increased risk of <\/span><a href=\"https:\/\/www.singlecare.com\/conditions\/pneumonia-treatment-and-medications\"><span style=\"font-weight: 400;\">pneumonia<\/span><\/a><span style=\"font-weight: 400;\"> has also been suggested but not proven.<\/span><\/p>\n<h3 id=\"malabsorption\"><span style=\"font-weight: 400;\">Malabsorption of nutrients<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Reducing the amount of acid in the stomach can affect nutrient absorption in the intestinal tract and may explain why certain nutrient levels can be low during therapy with Protonix or other PPIs. <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/26108134\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Hypomagnesemia<\/span><\/a><span style=\"font-weight: 400;\"> (low magnesium levels) occurs more frequently in those taking PPIs. Low magnesium levels can cause weakness, tremors, and adverse effects on the heart.\u00a0<\/span><\/p>\n<p><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/24327038\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Vitamin B12-deficiency<\/span><\/a><span style=\"font-weight: 400;\"> is more common during PPI treatment as well. A deficiency in vitamin B12 can lead to symptoms such as weakness, tiredness, and altered sensation and memory.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Calcium absorption is another concern for those taking PPIs like Protonix since calcium levels are one contributor to bone health. <\/span><a href=\"https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2012\/020987s045lbl.pdf\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">The Food and Drug Administration (FDA)<\/span><\/a><span style=\"font-weight: 400;\"> has placed a warning on Protonix and other PPIs about a possible elevated risk of osteoporosis-related fracture, related to thinning of the bones. Consuming more dairy products and eating more acidic meals to augment calcium absorption can both help to maintain adequate calcium levels, as can supplemental calcium citrate if advised by a healthcare professional.\u00a0<\/span><\/p>\n<h3 id=\"kidney-problems\"><span style=\"font-weight: 400;\">Kidney problems<\/span><\/h3>\n<p><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/26752337\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Clinical trials<\/span><\/a><span style=\"font-weight: 400;\"> have shown PPI use to be associated with a higher risk of chronic kidney disease. The association may simply be coincidental, as a direct causal link has not been proven. In addition, an acute kidney disease termed tubulointerstitial nephritis can occur in rare instances with Protonix and other PPI use. These risks, compared with the medication\u2019s benefits, are best discussed with the treating medical provider.<\/span><\/p>\n<h2 id=\"how-long-do-side-effects-last\"><span style=\"font-weight: 400;\">How long do Protonix side effects last?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Many adverse effects from Protonix, such as headache or mild diarrhea, can be expected to resolve shortly after stopping the medication. Others, like hypomagnesemia or c. diff infection, may require active treatment.<\/span><\/p>\n<h2 id=\"warnings\"><span style=\"font-weight: 400;\">Protonix contraindications and warnings<\/span><\/h2>\n<h3><span style=\"font-weight: 400;\">Abuse and dependence<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Protonix is not habit-forming. However, stopping Protonix abruptly after prolonged use may cause a rebound effect on gastric acid production and resultant GERD or heartburn symptoms. Discussing how best to stop Protonix with a healthcare professional is advisable, since they may recommend a gradual taper off the drug.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Overdose<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">The typical maximum oral dose of Protonix is 40 mg twice daily, but high doses are used occasionally. An overdose of Protonix warrants emergency medical attention and a call to the Poison Help line at 1-800-222-1222.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Restrictions<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Pre-existing low magnesium levels are reason for caution before initiating Protonix therapy. Age is another important consideration, as approval extends down only to age 5, and data from clinical studies in children younger than 5 years is limited.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Caution is advised before use during <\/span><a href=\"https:\/\/online.epocrates.com\/drugs\/222413\/Protonix\/Pregnancy-Lactation\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">pregnancy<\/span><\/a><span style=\"font-weight: 400;\"> due to potential risks and limited data. Similarly, given the paucity of <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK501280\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">clinical trials during lactation<\/span><\/a><span style=\"font-weight: 400;\">, it\u2019s believed that a limited amount of drug is excreted into breast milk but it\u2019s not known whether Protonix affects milk production. Careful discussion of potential risks and benefits is necessary before using Protonix while breastfeeding.<\/span><\/p>\n<h2 id=\"interactions\"><span style=\"font-weight: 400;\">Protonix interactions<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">The list of potential <\/span><a href=\"https:\/\/online.epocrates.com\/drugs\/222404\/Protonix\/Drug-Interactions\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">drug interactions<\/span><\/a><span style=\"font-weight: 400;\"> with Protonix is lengthy. Most of the interactions involve a change in the effectiveness of the other medication.<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Protonix should not be used with the <\/span><b>antiviral medications<\/b><span style=\"font-weight: 400;\"> nelfinavir and rilpivirine and avoidance in the setting of other antivirals, like atazanavir, may be advisable as well. The antiviral activity of the drugs could be negatively affected.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">The <\/span><b>antifungal ketoconazole<\/b><span style=\"font-weight: 400;\"> may also need to be avoided due to altered absorption and effectiveness.\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Warfarin, digoxin, and methotrexate<\/b><span style=\"font-weight: 400;\"> are some of the common medications with serious potential adverse reactions whose effects need to be closely monitored when taken concurrently with Protonix.<\/span><\/li>\n<\/ul>\n<h2 id=\"how-to-avoid-side-effects\"><span style=\"font-weight: 400;\">How to avoid Protonix side effects<\/span><\/h2>\n<ol>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Take Protonix delayed-release tablet or packet of granules on an empty stomach at least 30 minutes before the morning meal to maximize effectiveness.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Review your list of over-the-counter (OTC) and prescription drugs with the healthcare provider and inspect for interactions prior to starting Protonix and at every appointment.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">While Protonix may need to be used indefinitely, unnecessary long-term use of this drug is not uncommon, and the adverse effects of the drug become more of a concern over time. Consequently, it is worthwhile to discuss the intended duration of Protonix at each appointment. The discussion can also involve less potent alternatives like OTC antacids and <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/pepcid-complete\"><span style=\"font-weight: 400;\">Pepcid<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Monitoring magnesium and vitamin B12 levels may be recommended during long-term Protonix use.<\/span><\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>Common Protonix side effects | Headache | Diarrhea | Serious side effects | Infections | Malabsorption | Kidney problems | How long do side effects last? | Warnings | Interactions | How to avoid side effects Protonix (pantoprazole sodium) is a powerful stomach acid reducer, most renowned for its treatment benefits in gastroesophageal reflux disease [&hellip;]<\/p>\n","protected":false},"author":87,"featured_media":42510,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[4589],"tags":[16414,12752],"coauthors":[20732],"class_list":["post-42496","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-drug-info","tag-digestive-health","tag-medication-side-effects","wpautop"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Protonix side effects and how to avoid them<\/title>\n<meta name=\"description\" content=\"Headache and diarrhea are common Protonix side effects. 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