Drugs Q & A

Does Pantoprazole Cause Constipation, Dry mouth, or Bloating?

Constipation is a condition in which a person has uncomfortable or infrequent bowel movements. Generally, a person is considered to be constipated when bowel movements result in the passage of small amounts of hard, dry stool, usually fewer than three times a week. However, normal stool elimination may consist of having a bowel movement three times a day or three times a week; it depends on the person.

About 4 million people in the United States have frequent constipation. Constipation is the most common gastrointestinal complaint, resulting in 2.5 million doctor visits annually. This includes medication-induced constipation.

Hard, dry stools are the result of the colon absorbing too much water. Normally, as food moves through the colon (also known as the large intestine), the colon absorbs water while forming stool (waste products). Muscle contractions then push the stool toward the rectum, and, by the time the stool reaches the rectum, most of the water has been absorbed, making the stool solid.

When the colon’s muscle contractions are slow or sluggish, the stool moves through the colon too slowly, resulting in too much water being absorbed.

What is pantoprazole?

Pantoprazole is a prescription medication used to reduce the amount of stomach acid your body makes. It helps treat painful symptoms caused by conditions such as gastroesophageal reflux disease (GERD). With GERD, gastric juices flow upward from your stomach and into the esophagus.

Pantoprazole oral tablet is also used to treat other conditions in which the stomach makes excess acid, such as Zollinger-Ellison syndrome.

Pantoprazole comes in three forms: an oral tablet, an oral liquid suspension, and an intravenous (IV) form that’s injected into your vein by a healthcare professional.

How it works

Pantoprazole belongs to a class of drugs called proton pump inhibitors. It works to shut off the acid-pumping cells in your stomach. It reduces the amount of stomach acid and helps to reduce painful symptoms related to conditions such as GERD.

How should I take pantoprazole?

Pantoprazole comes as a delayed-release (releases the medication in the intestine to prevent break-down of the medication by stomach acids) tablet and as delayed-release granules to take by mouth. The packets of delayed-release granules must be mixed with applesauce or apple juice and taken by mouth or given through a feeding tube. For the treatment and maintenance of GERD, pantoprazole is usually taken once a day. For the treatment of conditions where the stomach produces too much acid, pantoprazole is usually taken twice a day. The delayed-release tablets are usually taken with or without food, and the granules are usually taken 30 minutes before a meal. Take pantoprazole at around the same time(s) every day.

The typical dosing for pantoprazole is as follows:

GERD: The typical dose for adults is 40 mg by mouth once daily for up to 8 weeks.

Zollinger-Ellison syndrome: The typical dose for adults is 40 mg by mouth twice daily.

Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take pantoprazole exactly as directed. Do not take more or less of it or take it more often or for a longer period of time than prescribed by your doctor.

Swallow the tablets whole; do not split, chew, or crush them. If your doctor has prescribed the 40 mg tablet and it is too big for you to swallow, ask your doctor to prescribe two of the 20 mg tablets instead.

To take the granules, open the packet and either sprinkle the granules onto one teaspoonful of applesauce or into a cup containing one teaspoonful of apple juice. Do not mix the granules with water, other liquids, or other foods. Use all of the granules in the packet; do not divide the granules into smaller doses. If you sprinkle the granules into apple juice, stir the mixture for 5 seconds. Swallow the mixture of applesauce or apple juice and medication right away (within 10 minutes) without chewing or crushing the granules. If you sprinkled the granules on applesauce, take several sips of water to wash the granules down to your stomach. If you sprinkled the granules into apple juice, rinse the cup once or twice with apple juice and drink the apple juice right away to be sure you swallow any leftover granules.

Pantoprazole granules mixed with apple juice may be given through a feeding tube. If you have a feeding tube, ask your doctor how you should take pantoprazole.

Continue to take pantoprazole even if you feel well. Do not stop taking pantoprazole without talking to your doctor. If your condition does not improve or gets worse, call your doctor.

Ask your pharmacist or doctor for a copy of the manufacturer’s information for the patient.

Does pantoprazole cause constipation dry mouth or bloating?

Yes, taking pantoprazole causes constipation, dry mouth, and bloating even though it is not a common side effect of the drug. Dry mouth and constipation associated with pantoprazole are more commonly reported in patients receiving triple therapy.

While taking pantoprazole you may also experience bloating and serious stomach conditions may occur while taking this medicine. Check with your doctor immediately if you or your child has stomach cramps, bloated feeling, watery and severe diarrhea which may also be bloody sometimes, fever, nausea or vomiting, or unusual tiredness or weakness.

What other side effects can this medication cause?

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

  • diarrhea
  • dizziness
  • gas
  • headache
  • joint pain
  • nausea
  • vomiting

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 that does not go away
  • new or worsening joint pain; rash on cheeks or arms that is sensitive to sunlight
  • 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 taking this medication.

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

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Dr. Oche Otorkpa PG Cert, MPH, PhD

Dr. Oche is a seasoned Public Health specialist who holds a post graduate certificate in Pharmacology and Therapeutics, an MPH, and a PhD both from Texila American University. He is a member of the International Society of Substance Use Professionals and a Fellow of the Royal Society for Public Health in the UK. He authored two books: "The Unseen Terrorist," published by AuthorHouse UK, and "The Night Before I Killed Addiction."
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