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26 years
I am taking pantozol 40 mg twice daily for my stomach problem. should i be worried for side effects on the long run since i cant stop this dose
Sep 4, 2014

Dr. Zakia Dimassi Pediatrics
If you are maintained on high doses and long-term use (1 year or longer) of pantoprazole, you should be on the lookout for the following conditions:
Atrophic Gastritis
Atrophic gastritis, in which the inner linings of the stomach become unhealthy and weather off, has been noted occasionally in patients treated long-term with Pantoprazole sodium, particularly in patients who were H. pylori positive.
Cyanocobalamin (Vitamin B-12) Deficiency
Generally, daily treatment with any acid-suppressing medications over a long period of time (e.g., longer than 3 years) may lead to malabsorption of cyanocobalamin (Vitamin B-12) caused by hypo- or achlorhydria, i.e., inadequate stomach acidity.
Clostridium difficile associated diarrhea
Published observational studies suggest that proton pump inhibitor (PPI) therapy like Pantoprazole sodium may be associated with an increased risk of Clostridium difficile (a type pf bacteria) associated diarrhea, especially in hospitalized patients. This diagnosis should be considered for diarrhea that does not improve.
Patients should use the lowest dose and shortest duration of PPI therapy appropriate to the condition being treated.
Bone Fracture
Numerous studies suggest that PPI therapy may be associated with an increased risk for osteoporosis-related fractures of the hip, wrist, or spine. The risk of fracture was increased in individuals maintained on high-dose therapy, defined as multiple daily doses, and long-term PPI therapy (a year or longer). Patients should use the lowest dose and shortest duration of PPI therapy appropriate to the condition being treated.
Hypomagnesemia (low blood magnesium)
Hypomagnesemia, whether with or without physical symptoms, has been reported rarely in patients treated with PPIs for at least three months, in most cases after a year of therapy.
Discuss the above possible complications with your treating physician and devise with him/her a plan in order to monitor indicators of possible side effects of treatment. So for example, you could do regular blood magnesium level measurement.
The following recommendations for lifestyle and dietary changes may also help to relieve heartburn or acid related symptoms.
- Avoid large meals
- Eat slowly
- Stop smoking
- Reduce alcohol and caffeine consumption
- Reduce weight (if overweight)
- Avoid tight-fitting clothing or belts
- Avoid eating less than three hours before bedtime
- Elevate bedhead (if you suffer from nocturnal symptoms)
- Reduce intake of food that can cause heartburn. These might include: Chocolate, peppermint, spearmint, fatty and fried food, acidic food, spicy food, citrus fruits and fruit juices, tomatoes.
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