Diarrhea pantoprazole

The prodrugs are unstable in the presence of acid and therefore must be administered as an enteric-coated preparation or as a buffered suspension. Pantoprazole is also available in an intravenous formulation. The most commonly reported side effects are diarrhea and headache. Hypergastrinemia has been noted as a reaction to the marked reduction in acid secretion. Gastric carcinoid tumors have developed in rats but not in mice or in human volunteers, even after long-term use. 

Pantoprazole 40 mg/day and ranitidine 150 mg bd for 8 weeks have been compared in the treatment of grades II and III reflux esophagitis in a randomized, double-bhnd trial in 256 patients (1). Symptom rehef and healing rates were significantly better with pantoprazole. The incidences of adverse effects were similar in the two groups the most commonly reported were diarrhea and somnolence with pantoprazole (2-3%) and headache, diarrhea, dizziness, increases in liver enzymes, and pruritus (2 %) with ranitidine. 

Pantoprazole 20 mg/day and ranitidine 300 mg/day for 12 months have been compared in the relief of symptoms in a multicenter, randomized, double-blind trial in 307 patients with symptomatic gastro-esophageal reflux disease in primary care (3). Symptom control was significantly more effective and faster with pantoprazole than ranitidine. Adverse effects were similar in the two groups the most common adverse effects were headache, diarrhea, nausea, constipation, and vomiting. 

Omeprazole multiple unit pellet system (MUPS) 20 mg/day and pantoprazole 40 mg/day for 8 weeks were more effective than lansoprazole 30 mg/day in relieving heartburn in a randomized, double-bhnd trial in 461 patients with sjmptomatic reflux esophagitis (15). Patient satisfaction and adverse effects were similar in the three groups. The most common adverse effects were diarrhea, headache, and nausea. 

Pantoprazole 20 mg/day and omeprazole 20 mg/day for 8 weeks have been compared in the treatment of grade I reflux esophagitis in a multicenter, randomized, open trial in 328 patients (21). Symptom rehef and heahng rates were similar and both treatments were well tolerated. There was no significant difference in reported adverse events between the groups. The most commonly reported were nausea, diarrhea, and headache. 

The adverse effects profile of the proton pump inhibitors during short-term administration (under 12 weeks) is similar to that reported with short-term use of histamine receptor antagonists. The type and frequency of adverse effects reported with lansoprazole, omeprazole, pantoprazole, and rabeprazole are comparable. The most common adverse effects include headache, diarrhea, nausea, abdominal pain, constipation, dizziness, and skin rashes. 

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