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Below is important safety information regarding the use of pantoprazole (Protonix). Please review these details carefully and consult your healthcare provider if you have any questions or concerns.

• Masking Severe Conditions: Frequent heartburn may be indicative of more serious conditions such as stomach cancer. If your heartburn worsens or recurs after taking pantoprazole, or if you experience symptoms like poor appetite, unexplained weight loss, or weakness, consult your healthcare professional promptly.

• Kidney Issues: There is a potential risk of sudden kidney problems while taking pantoprazole. Symptoms may include changes in urination, nausea, weakness, fever, rash, or joint pain. Report these symptoms to your healthcare provider immediately.

• Infectious Diarrhea: Pantoprazole may increase the risk of a bacterial infection called Clostridioides difficile, especially in individuals over 65, those recently in hospitals or nursing homes, or with weakened immune systems. To minimize this risk, use the lowest effective dose for the shortest duration. Contact your healthcare provider if you experience severe diarrhea, fever, abdominal pain, loss of appetite, or nausea.

• Bone Fracture Risk: Long-term use or high doses of pantoprazole may increase the risk of fractures, particularly in the hip, wrist, or spine. Discuss your risk with your provider if you have a history of fractures or osteoporosis.

• Skin Reactions: Rare but serious skin reactions such as Stevens-Johnson syndrome or toxic epidermal necrolysis may occur. Seek medical attention immediately if you experience symptoms like fever, body aches, rash, blistering, or facial swelling.

• Lupus Symptoms: Pantoprazole may trigger new or worsening lupus symptoms, such as joint pain or rash. These symptoms usually improve after discontinuing the medication. Consult your provider if you experience lupus symptoms.

• Vitamin and Mineral Deficiencies: Long-term use of pantoprazole can lead to low vitamin B12 or magnesium levels. If you experience symptoms such as dizziness, muscle weakness, pale skin, fatigue, or tingling sensations, discuss these with your healthcare provider.

• Drug Interactions: Pantoprazole can affect the efficacy of other medications, notably Edurant (rilpivirine) used for HIV treatment. Avoid taking these medications together to prevent reduced effectiveness of Edurant.

• Laboratory Interference: This medication may affect the results of certain tumor screenings or drug tests. Inform your healthcare provider about your use of pantoprazole before undergoing any tests, as you may need to stop the medication temporarily.

Contraindications:

• Do not use pantoprazole if you have a history of allergy to proton pump inhibitors (PPIs) or if you are taking Edurant (rilpivirine) or other rilpivirine-containing medications. Consult your healthcare provider for alternative treatment options.

This medication may cause some common side effects, including headache, diarrhea, nausea, and abdominal pain. These are generally mild but if they persist or worsen, consider discussing them with your healthcare provider. Some individuals may also experience vomiting, excessive gas, dizziness, or joint pain. Again, these effects are usually not severe, but it's important to monitor them.

There are rare but serious side effects associated with this medication that require immediate medical attention. These include severe stomach pain or diarrhea, which can be signs of a serious bacterial infection. Kidney problems may manifest as changes in urination, fever, or poor appetite. Symptoms of lupus, such as joint pain or a rash on the face that worsens in sunlight, should also be monitored closely. Additionally, serious skin reactions characterized by blistering, peeling, or bleeding, as well as fever and chills, are critical conditions that need urgent care.

In rare cases, the medication can cause a vitamin B-12 deficiency if used daily for an extended period (three years or more). You should be aware of symptoms like unusual weakness, a sore tongue, or numbness and tingling in the hands or feet. A very serious allergic reaction, though rare, could include symptoms such as fever, swollen lymph nodes, rash, itching or swelling of the face, tongue, or throat, severe dizziness, or trouble breathing. If you notice any of these symptoms, seek medical help immediately. Remember, this is not a comprehensive list of side effects, and if you notice any other unusual symptoms, it is important to contact your healthcare provider.

Pantoprazole, also known as Protonix, can interact with some medications and supplements. It’s important to inform your doctor and pharmacist about all other medications you are taking, including prescription, over-the-counter drugs, vitamins, and herbal supplements.

One drug that should generally not be used with Pantoprazole is Rilpivirine. If you are taking both, your doctor might choose to adjust your treatment plan.

For certain other drugs, Pantoprazole may not be recommended, but in some cases, it might be necessary to use them together with adjustments. These include Methotrexate, Atazanavir, Erlotinib, Nelfinavir, Pazopanib, Ketoconazole, and others. Pantoprazole reduces stomach acid, which can affect the absorption and effectiveness of these medications.

Additionally, using Pantoprazole with Levothyroxine or Warfarin might increase the risk of side effects. If these combinations are prescribed, your doctor may alter the dosage or frequency of your medications to manage potential interactions.

Lastly, Pantoprazole might interfere with some lab tests, potentially causing inaccurate results. Therefore, ensure that all healthcare providers and lab personnel are aware that you are taking this medication.