Last update Aug. 30, 2022

Pantoprazole

Compatible

Safe substance and/or breastfeeding is the best option.

Pantoprazole is a proton pump inhibitor with actions and uses similar to those of omeprazole. Indicated in the treatment of peptic ulcer and gastroesophageal reflux. Oral administration once daily.

It is excreted in breast milk in clinically insignificant amounts (Bor 2017, Plante 2004). Its very high percentage of protein binding explain the negligible passage into breast milk observed.

Non-acid-fast forms of pantoprazole are destroyed in the stomach. Since it's neutralized by the acid pH of stomach, capsules with enteric coated granules are used. Because of this, it is thought that the small quantity of Pantoprazole that may reach the breast milk would be neutralized by infant's stomach. In addition, absorption is greatly decreased by the presence of food. 

It can cause gynecomastia, galactorrhea and hyperprolactinemia. (Ashfaq 2022)

Several medical societies and expert authors consider the use of this medication possible during breastfeeding. (Hale, LactMed, Briggs 2015, Schaefer 2015, Rowe 2013, Nava 2006)

Alternatives

We do not have alternatives for Pantoprazole since it is relatively safe.

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Pantoprazole is also known as


Pantoprazole in other languages or writings:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 77 (67 - 89) %
Molecular weight 382 daltons
Protein Binding 98 %
VD 0.16 - 0.34 l/Kg
pKa 9.15 -
Tmax 2. 5 (2 - 3) hours
1 - 1.5 hours
M/P ratio 0.03 -
Theoretical Dose 0.0054 mg/Kg/d
Relative Dose 0.4 - 0.8 %

References

  1. LactMed. Drugs and Lactation Database (LactMed). Internet. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/ 2006 - Consulted on April 16, 2024 Full text (link to original source)
  2. Hale TW. Medications & Mothers' Milk. 1991- . Springer Publishing Company. Available from https://www.halesmeds.com Consulted on April 10, 2024 Full text (link to original source)
  3. Ashfaq M, Haroon MZ, Alkahraman YM. Proton pump inhibitors therapy and risk of hyperprolactinemia with associated sexual disorders. Endocr Regul. 2022 Apr 30;56(2):134-147. Abstract Full text (link to original source)
  4. Bor S, Karacaoglu S, Ergun P, Kipcak S, Turkyilmaz G, Karasulu E. The levels of pantoprazole in human breast milk and plasma: Two compartment model. Neurogastroenterol Motil 2017;29:79-80. Abstract 157. Abstract Full text (link to original source) Full text (in our servers)
  5. Briggs GG, Freeman RK, Towers CV, Forinash AB. Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk. Wolters Kluwer Health. Tenth edition (acces on line) 2015
  6. Schaefer C, Peters P, Miller RK. Drugs During Pregnancy and Lactation. Treatment options and risk assessment. Elsevier, Third Edition. 2015
  7. Rowe H, Baker T, Hale TW. Maternal medication, drug use, and breastfeeding. Pediatr Clin North Am. 2013 Feb;60(1):275-94. Abstract
  8. Nava-Ocampo AA, Velázquez-Armenta EY, Han JY, Koren G. Use of proton pump inhibitors during pregnancy and breastfeeding. Can Fam Physician. 2006 Abstract Full text (link to original source) Full text (in our servers)
  9. Plante L, Ferron GM, Unruh M, Mayer PR. Excretion of pantoprazole in human breast. J Reprod Med. 2004 Abstract
  10. Dammann HG, Bethke T, Burkhardt F, Wolf N, Khalil H, Luehmann R. Effects of pantoprazole on endocrine function in healthy male volunteers. Aliment Pharmacol Ther. 1994 Abstract
  11. Pue MA, Laroche J, Meineke I, de Mey C. Pharmacokinetics of pantoprazole following single intravenous and oral administration to healthy male subjects. Eur J Clin Pharmacol. 1993 Abstract

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