Drugs Home > Pantoprazole Precautions and Warnings

In the case of pantoprazole, precautions and warnings to be aware of include the risk of experiencing a vitamin B-12 deficiency as a result of taking the medication. Pantoprazole is considered a pregnancy category B drug, which means that it has not been studied in pregnant women. Women who are pregnant should discuss the safety of taking pantoprazole with their healthcare provider. Other precautions and warnings for pantoprazole users include avoiding nursing while taking the drug.

Pantoprazole Precautions and Warnings: An Introduction

Pantoprazole sodium ("pantoprazole") is a prescription medication sold under the brand name Protonix® that is used to treat a number of conditions within the esophagus, stomach, and intestines.
Before taking pantoprazole, let your healthcare provider know if you:
  • Have liver disease or liver failure
  • Have low blood magnesium (hypomagnesemia) 
  • Are pregnant or breastfeeding
  • Have any allergies.
It is important to tell your healthcare provider about all of the medicines that you are taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.

Some Pantoprazole Precautions and Warnings

Precautions and warnings to be aware of while taking pantoprazole include the following:
  • Studies indicate that people who take proton pump inhibitor medications (such as pantoprazole) may be at an increased risk for broken bones. The risk appears to be highest for people who take such medications at high doses or for long periods (over a year). You and your healthcare provider should take this into account when deciding if the benefits of this medication outweigh the risks for your particular situation.


  • The use of proton pump inhibitors (including this medication) may increase the risk of a potentially serious condition known as Clostridium difficile-associated diarrhea (CDAD). If you develop diarrhea that does not seem to improve (especially if it is watery and accompanied by a fever and abdominal pain), seek immediate medical attention. 


  • Proton pump inhibitors (PPIs), including pantoprazole, may cause low blood magnesium levels (hypomagnesemia). Seek immediate medical attention if you develop any symptoms of hypomagnesemia, such as muscle spasms, an irregular heart rhythm (arrhythmia), or seizures. Your healthcare provider may want to check your magnesium levels periodically using a simple blood test. 


  • Pantoprazole is considered a pregnancy category B medication. This means that it has not been studied in pregnant women. However, when studied in animals, it showed no negative effects on unborn babies. If you are pregnant, talk to your healthcare provider about the safety of taking pantoprazole in your situation.
  • It is not known whether pantoprazole passes through breast milk. Therefore, women who are taking pantoprazole should avoid nursing.
  • In general, acid-suppressing medications may interfere with the absorption of vitamin B-12, which means that there is a slight risk of developing a B-12 deficiency. Discuss this with your healthcare provider if you have concerns.
Written by/reviewed by:
Last reviewed by: Kristi Monson, PharmD;
Last updated/reviewed:
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