Pantoprazole reduces the amount of acid your stomach makes.

It's used for heartburn, acid reflux and gastro-oesophageal reflux disease (GORD) - GORD is when you keep getting acid reflux. It's also taken to prevent and treat stomach ulcers.

Sometimes, pantoprazole is taken for a rare illness caused by a tumour in the pancreas or gut called Zollinger-Ellison syndrome.

Pantoprazole comes as tablets. It also comes as liquid that you swallow.

All types of pantoprazole are available on prescription. You can buy lower-strength 20mg tablets from pharmacies for heartburn or acid reflux.

• It's usual to take pantoprazole once a day in the morning.
• Common side effects include headaches, constipation or diarrhoea, wind, stomach pain, feeling or being sick. These tend to be mild and go away when you stop taking the medicine.
• If you've bought pantoprazole without a prescription and your symptoms don't improve after 2 weeks, see a doctor before taking any more.
• Pantoprazole isn't usually recommended during pregnancy.
• Pantoprazole is also called by the brand name Pantoloc Control.

Pantoprazole can be taken by adults and children aged 12 years and over. It is not generally recommended during pregnancy.

Pantoprazole isn't suitable for some people. To make sure that it is safe for you, tell your doctor if you:

• have had an allergic reaction to pantoprazole or any other medicine in the past
• have liver problems
• are due to have an endoscopy

Ask your doctor if you should stop taking pantoprazole a few weeks before your endoscopy. This is because pantoprazole may hide some of the problems that would usually be spotted during an endoscopy.

It's usual to take pantoprazole once a day, first thing in the morning.

If you take pantoprazole twice a day, take 1 dose in the morning and 1 dose in the evening.

It's best to take pantoprazole an hour before a meal. Swallow tablets whole with a drink of water.

How much will I take?

Each tablet contains 20mg or 40mg of pantoprazole. You can buy pantoprazole 20mg tablets from pharmacies. These are suitable for the short-term treatment of heartburn and acid reflux in adults.

Liquid pantoprazole can be prescribed for people who cannot swallow tablets. It will come with a syringe or spoon to help you take the right amount. If you don't have a syringe or spoon, ask your pharmacist for one.

The usual dose to treat:

• heartburn and acid reflux is 20mg a day
• gastro-oesophageal reflux disease is 20mg to 40mg a day
• stomach ulcers is 20mg to 40mg a day
• Zollinger-Ellison syndrome is 40mg to 80mg a day - this can increase to 160mg a day depending on how well it works for you

Will my dose go up or down?

Sometimes your doctor will increase your dose of pantoprazole if it isn't working well enough.

Depending on the reason you take pantoprazole, you may take a higher dose to begin with, usually for a month or two. After this, your doctor may recommend that you take a lower dose.

How long will I take it for?

If you buy pantoprazole from a pharmacy, you can usually take it for up to 2 weeks. After 2 weeks:

• if your symptoms have improved - you can take it for another 2 weeks
• if your symptoms haven't improved - or they are worse, speak to a doctor before taking any more pantoprazole

Do not take pantoprazole for more than 4 weeks without speaking to your doctor first. If your symptoms haven't improved, you may need some tests to find out what's causing them.

If you take it on prescription, you may only need to take it for a few weeks or months, depending on your illness. Sometimes your doctor may advise you to take it for longer, even for many years.

Your doctor may suggest taking pantoprazole only when you have symptoms. This means you won't have to take it every day. Once you feel better, you can stop taking it - often after a few days or weeks. Taking pantoprazole this way isn't suitable for everyone. Speak to your doctor about what's best for you.

What if I forget to take it?

If you usually take it:

• once a day - take the missed dose as soon as you remember, unless your next dose is due in less than 12 hours in which case skip the missed dose. Take your next dose at the usual time, and then carry on as normal.
• twice a day - take the missed dose as soon as you remember, unless your next dose is due in less than 4 hours in which case skip the missed dose. Take your next dose at the usual time, and then carry on as normal.

Never take a double dose to make up for a forgotten dose. If you often forget doses, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to remember your medicine.

What if I take too much?

It is very unlikely that taking one or two extra doses by accident will cause any problems. However, you should check with your doctor if you have taken too much and have any of these symptoms:

• flushed skin
• feeling sweaty
• a fast heartbeat
• feeling sleepy
• blurred vision
• feeling confused or agitated

Most people who take pantoprazole do not have any side effects. If you do get a side effect, it is usually mild and will go away when you stop taking pantoprazole.

Talk to your pharmacist or doctor if these side effects bother you or don't go away:

• headaches
• diarrhoea
• feeling sick or being sick (nausea or vomiting)
• constipation
• stomach pain or wind

Serious side effects

Serious side effects are rare and happen in less than 1 in 1,000 people.

Call a doctor straight away if you have:

• joint pain and a red skin rash, especially in parts of your body exposed to the sun, such as your arms, cheeks and nose. These can be signs of a rare condition called subacute cutaneous lupus erythematosus. This can happen even if you've been taking pantoprazole for a long time.
• stomach pain that gets worse, yellow skin (or the whites of your eyes turn yellow), dark pee. These can be signs of liver problems.
• pain when you pee, peeing less, lower back pain, swollen ankles, and rash or fever. These could be signs of a kidney problem.

Serious allergic reaction

In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to pantoprazole.

These are not all the side effects of pantoprazole. For a full list see the leaflet inside your medicine packet.

What to do about:

• headaches - make sure you rest and drink plenty of fluids. Do not drink too much alcohol. Ask your pharmacist to recommend a painkiller. Headaches usually go away after the first week of taking pantoprazole. Talk to your doctor if they last longer than a week or are severe.
• diarrhoea - drink plenty of water by having small, frequent sips to avoid dehydration. Signs of dehydration include peeing less than usual or having strong-smelling pee. Do not take any other medicines to treat diarrhoea without speaking to a pharmacist or doctor.
• feeling sick or being sick (nausea or vomiting) - stick to simple meals and do not eat rich or spicy food. If you're vomiting, try small frequent sips of water. Do not take any other medicines to treat vomiting without speaking to a pharmacist or doctor.
• constipation - get more fibre into your diet such as fresh fruit and vegetables and cereals, and drink plenty of water. Try to exercise, for example, by going for a daily walk or run. If this doesn't help, talk to your pharmacist or doctor.
• stomach pain or wind - steer clear of foods that cause wind, such as lentils, beans and onions. It might also help to eat smaller and more frequent meals, eat and drink slowly, and exercise regularly. Some pharmacy remedies, such as simethicone, may relieve the symptoms of wind.

Pantoprazole isn't usually recommended during pregnancy as there's no firm evidence it's safe.

A medicine called omeprazole, which is similar to pantoprazole, is safe in pregnancy.

However, if you're pregnant, it's better to try to treat your symptoms without taking a medicine.

Your doctor or midwife may suggest eating smaller meals more often and avoiding fatty and spicy foods.

They may also suggest that you raise the head of your bed 10 to 20cm by putting something under your bed or mattress, so that your chest and head are above your waist. This helps stop stomach acid travelling up towards your throat.

If these lifestyle changes don't work, you may be recommended omeprazole, which is safe to take during pregnancy.

Pantoprazole and breastfeeding

Pantoprazole is safe to take while you're breastfeeding. It passes into breastmilk, but only in small amounts that aren't harmful to the baby.

If your baby is premature or has health problems, check with your doctor before taking pantoprazole.

Some medicines can interfere with pantoprazole and make you more likely to have side effects.

Tell your doctor if you're taking these medicines before you start pantoprazole treatment:

• digoxin (a heart medicine)
• antifungal medicines such as itraconazole, ketoconazole, posaconazole and voriconazole
• methotrexate (a medicine used to treat cancer, psoriasis and rheumatoid arthritis)
• HIV medicines
• rifampicin (an antibiotic)
• blood-thinning medicines, such as clopidogrel and warfarin

Mixing pantoprazole with herbal remedies and supplements

Do not take St John's wort, the herbal remedy for depression, while you're taking pantoprazole. St John's wort may stop pantoprazole working as well as it should.