Pantoprazole

What it is

Pantoprazole is a proton pump inhibitor that blocks the enzyme responsible for secreting acid in the stomach lining, lowering acid output through the day. It is used for heartburn and reflux and for treating and preventing stomach and duodenal ulcers. Its effect builds over a few days rather than working immediately on contact.

Used for

• Heartburn
• Ulcer

What to know while taking it

It is taken on an empty stomach ahead of the morning meal, because the acid pumps it blocks are switched on by eating. Reduced stomach acid impairs absorption of vitamin B12, magnesium and iron, so magnesium and vitamin B12 are the values to watch on longer courses. It alters absorption of levothyroxine, so thyroid replacement may need re-checking when the two are used together. The need for a long course is meant to be reviewed rather than continued indefinitely.

When to see a doctor

See a doctor if symptoms persist or return despite treatment, or if there is difficulty swallowing, unexplained weight loss, vomiting of blood or black tarry stools. Muscle cramps, an irregular heartbeat, tingling or unusual tiredness during a long course also warrant a check.

Worth knowing

• Reassess the need for long courses

Markers to watch

• Magnesium
• Vitamin B12

Nutrients affected

• vitaminB12 — depleted by (Hemoglobin, Homocysteine, Mean cell volume (MCV))
• magnesium — depleted by (Glucose, HOMA-IR, Magnesium)
• iron — absorption blocked with (Ferritin, Hematocrit, Hemoglobin)