Pantoprazole injection is used as a short-term treatment to treat gastroesophageal reflux disease (GERD; a condition in which backward flow of acid from the stomach causes heartburn and possible injury of the esophagus [the tube between the throat and stomach]) in people who have had damage to their esophagus and who are unable to take pantoprazole by mouth. It is also used to treat conditions where the stomach produces too much acid, such as Zollinger-Ellison syndrome (tumors in the pancreas and small intestine that caused increased production of stomach acid). Pantoprazole is in a class of medications called proton-pump inhibitors. It works by decreasing the amount of acid made in the stomach.

Pantoprazole injection comes as a powder to be mixed with liquid and given intravenously (into a vein) by a doctor or nurse in a medical facility. For the treatment of GERD, pantoprazole injection is usually given once a day for 7 to 10 days. For the treatment of conditions where the stomach produces too much acid, pantoprazole injection is usually given every 8 to 12 hours.

Before receiving pantoprazole,

• tell your doctor and pharmacist if you are allergic to pantoprazole, dexlansoprazole (Dexilant), esomeprazole (Nexium, in Vimovo), lansoprazole (Prevacid), omeprazole (Prilosec, in Zegerid), rabeprazole (AcipHex), any other medications, or any of the ingredients in pantoprazole injection. Ask your pharmacist for a list of the ingredients.
• tell your doctor if you are taking rilpivirine (Edurant, in Cabenuva, Complera, Juluca, Odefsey). Your doctor will probably tell you not to receive pantoprazole injection if you are taking this medication.
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: atazanavir (Reyataz, in Evotaz), dasatinib (Sprycel), digoxin (Lanoxin), diuretics ('water pills'), erlotinib (Tarceva), iron supplements, itraconazole ( Sporanox, Tolsura), ketoconazole, methotrexate (Trexall, Xatmep), mycophenolate (Cellcept, Myfortic), nelfinavir (Viracept), nilotinib (Tasigna), saquinavir (Invirase), and warfarin ( Jantoven). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• tell your doctor if you have or have ever had a low level of zinc, magnesium, or calcium in your body; osteoporosis (a condition in which the bones become thin and weak and break easily); or an autoimmune disease (condition that develops when the immune system attacks healthy cells in the body by mistake) such as systemic lupus erythematosus.
• tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while receiving pantoprazole injection, call your doctor.

Your doctor may tell you to take zinc supplements during your treatment.

Pantoprazole injection may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• headache
• vomiting
• joint pain
• diarrhea
• dizziness
• pain, redness, or swelling near the place the medication was injected

Some side effects may be serious. If you experience any of the following symptoms, call your doctor immediately, or get emergency medical help:

• blistering, peeling, or bleeding skin; sores on the lips, nose, mouth, or genitals; swollen glands; shortness of breath; fever; or flu-like symptoms
• rash hives; itching; swelling of the eyes, face, lips, mouth, throat, or tongue; difficulty breathing or swallowing; or hoarseness
• irregular, fast, or pounding heartbeat; muscle spasms; uncontrollable shaking of a part of the body; excessive tiredness; lightheadedness; dizziness; or seizures
• severe diarrhea with watery stools, stomach pain, or fever
• new or worsening joint pain; rash on cheeks or arms that is sensitive to sunlight, joint pain
• abdominal pain or soreness, blood in your stool
• increased or decreased urination, blood in urine, fatigue, nausea, loss of appetite, fever, rash, or joint pain

Pantoprazole may cause other side effects. Call your doctor if you have any unusual problems while receiving this medication.

People who receive proton pump inhibitors such as pantoprazole may be more likely to fracture their wrists, hips, or spine than people who do not receive one of these medications. People who receive proton pump inhibitors may also develop fundic gland polyps (a type of growth on the stomach lining). These risks are highest in people who receive high doses of one of these medications or receive them for one year or longer. Talk to your doctor about the risks of receiving pantoprazole.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Keep all appointments with your doctor and the laboratory. Your doctor may order certain laboratory tests before and during your treatment.

Before having any laboratory test, tell your doctor and the laboratory personnel that you are receiving pantoprazole.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

• Protonix I.V.®