Uses of Protonix:

• It is used to treat gastroesophageal reflux disease (GERD; acid reflux).
• It is used to treat syndromes caused by lots of stomach acid.
• It may be given to you for other reasons. Talk with the doctor.

What do I need to tell my doctor BEFORE I take Protonix?

• If you have an allergy to pantoprazole or any other part of Protonix (pantoprazole delayed-release granules).
• If you are allergic to Protonix (pantoprazole delayed-release granules); any part of Protonix (pantoprazole delayed-release granules); or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
• If you are taking any of these drugs: Atazanavir, nelfinavir, or rilpivirine.

This is not a list of all drugs or health problems that interact with Protonix (pantoprazole delayed-release granules).

Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take Protonix (pantoprazole delayed-release granules) with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

What are some things I need to know or do while I take Protonix?

• Tell all of your health care providers that you take Protonix (pantoprazole delayed-release granules). This includes your doctors, nurses, pharmacists, and dentists.
• Do not take Protonix (pantoprazole delayed-release granules) for longer than you were told by your doctor.
• This medicine may affect certain lab tests. Tell all of your health care providers and lab workers that you take Protonix (pantoprazole delayed-release granules).
• Call your doctor if you have throat pain, chest pain, very bad belly pain, trouble swallowing, or signs of a bleeding ulcer like black, tarry, or bloody stools, throwing up blood, or throw up that looks like coffee grounds. These may be signs of a worse health problem.
• This medicine may raise the chance of hip, spine, and wrist fractures in people with weak bones (osteoporosis). The chance may be higher if you take Protonix (pantoprazole delayed-release granules) in high doses or for longer than a year, or if you are older than 50 years old.
• Use care if you have risks for soft, brittle bones (osteoporosis). Some of these risks include drinking alcohol, smoking, taking steroids, taking drugs to treat seizures, or having family members with osteoporosis. Talk with your doctor about your risks of osteoporosis.
• Rarely, low magnesium levels have happened in people taking drugs like this one for at least 3 months. Most of the time, this happened after 1 year of treatment. You will need to have blood work if you take Protonix (pantoprazole delayed-release granules) for a long time or with certain other drugs.
• Long-term treatment (for instance longer than 3 years) with drugs like this one has rarely caused low vitamin B-12 levels. Talk with the doctor.
• Tell your doctor if you are pregnant, plan on getting pregnant, or are breast-feeding. You will need to talk about the benefits and risks to you and the baby.

How is this medicine (Protonix) best taken?

Use Protonix (pantoprazole delayed-release granules) as ordered by your doctor. Read all information given to you. Follow all instructions closely.

• Take 30 minutes before a meal.
• Mix granules with 1 teaspoon of applesauce or 1 teaspoon (5 mL) of apple juice. Do not mix with other foods or liquids. Take the dose within 10 minutes of mixing. Do not chew or crush the granules.
• Keep taking Protonix (pantoprazole delayed-release granules) as you have been told by your doctor or other health care provider, even if you feel well.
• Those who have feeding tubes may use Protonix (pantoprazole delayed-release granules). Use as you have been told. Flush the feeding tube after Protonix (pantoprazole delayed-release granules) is given.

What do I do if I miss a dose?

• Take a missed dose as soon as you think about it.
• If it is close to the time for your next dose, skip the missed dose and go back to your normal time.
• Do not take 2 doses at the same time or extra doses.

What are some side effects that I need to call my doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
• Signs of low magnesium levels like mood changes, muscle pain or weakness, muscle cramps or spasms, seizures, shakiness, not hungry, very bad upset stomach or throwing up, or a heartbeat that does not feel normal.
• Signs of kidney problems like unable to pass urine, change in how much urine is passed, blood in the urine, or a big weight gain.
• Bone pain.
• Fever.
• Lupus has happened with Protonix (pantoprazole delayed-release granules), as well as lupus that has gotten worse in people who already have it. Tell your doctor if you have lupus. Call your doctor right away if you have signs of lupus like a rash on the cheeks or other body parts, sunburn easy, muscle or joint pain, chest pain or shortness of breath, or swelling in the arms or legs.
• This medicine may raise the chance of a severe form of diarrhea called C diff-associated diarrhea (CDAD). Call your doctor right away if you have stomach pain or cramps, very loose or watery stools, or bloody stools. Do not try to treat diarrhea without first checking with your doctor.
• A very bad skin reaction (Stevens-Johnson syndrome/toxic epidermal necrolysis) may happen. It can cause very bad health problems that may not go away, and sometimes death. Get medical help right away if you have signs like red, swollen, blistered, or peeling skin (with or without fever); red or irritated eyes; or sores in your mouth, throat, nose, or eyes.

What are some other side effects of Protonix?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

• Headache.
• Stomach pain or diarrhea.
• Upset stomach or throwing up.
• Gas.
• Dizziness.
• Joint pain.
• Signs of a common cold.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at https://www.fda.gov/medwatch.

If OVERDOSE is suspected:

If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

How do I store and/or throw out Protonix?

• Store at room temperature.
• Store in a dry place. Do not store in a bathroom.
• Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
• Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

Consumer Information Use and Disclaimer

• If your symptoms or health problems do not get better or if they become worse, call your doctor.
• Do not share your drugs with others and do not take anyone else's drugs.
• This medicine comes with an extra patient fact sheet called a Medication Guide. Read it with care. Read it again each time Protonix (pantoprazole delayed-release granules) is refilled. If you have any questions about Protonix (pantoprazole delayed-release granules), please talk with the doctor, pharmacist, or other health care provider.
• If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

Frequently asked questions

• Pantoprazole vs. omeprazole: What's the difference between them?
• Can you take pantoprazole 40 mg twice a day?
• How long can I take pantoprazole?
• Does pantoprazole cause bloating?

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