The usual dosage for pantoprazole 40mg is 40mg once a day if you are buying it without a prescription or a physician's evaluation of your symptoms. The only conditions that pantoprazole 40mg twice a day is recommended for are those characterized by excessively high gastric acid secretion such as Zollinger Ellison syndrome, and if you have these conditions then you should be under the care of a physician. Studies have shown that for reflux, dyspepsia, or GERD, dosages higher than 40mg did not offer any further significant lowering of stomach acid than 40mg dosages.

What is wrong with taking pantoprazole 40mg twice a day?

Taking more pantoprazole than recommended, such as pantoprazole 40mg twice a day, is not any more effective than 40mg once a day for GERD symptoms, and can mask more serious underlying conditions, such as severe ulcers or reflux disease. In addition, there is a higher risk of side effects.

If you find you have to increase your dose of pantoprazole to relieve your symptoms, then you should ask your physician for a full check-up, especially if one of the following applies to you:

• age ≥50, or ≥40 years and of African, Hawaiian, Pacific, or Asian descent with stomach symptoms
• have someone in your family who has, or has had, gastric cancer and was younger than 50
• have symptoms that are severe, persistent, occur at night, or include an ongoing cough
• have blood in your stools, or your stools look black or tarry
• are vomiting regularly, or there is blood in your vomit
• have difficulty swallowing or can feel a lump in your torso
• have previously had a stomach ulcer or taken aspirin, NSAIDs, or prednisone
• you seem iron deficient
• have lost weight recently for no apparent reason.