LMW asked
I am wondering about Protonix side effects. I took it for a week and started to have nausea, dizziness and lower abdominal pain and gas along with extreme fatigue. My last dose (40mg) was Saturday (today is Monday). I woke up with bad nausea and lower abdominal discomfort. How long does it take to get out of my system?
Answer
Protonix (pantoprazole), a proton pump inhibitor (PPI), has a very short elimination half-life, around one hour according to the prescribing information for the drug. However, the half-life of Protonix will significantly increase in those will liver disease, to around 7-9 hours. In addition, a small percentage of people may have a generic mutation to the metabolizing enzyme CYP2C19, which reduces how quickly the drug is metabolized, potentially extending the half-life of Protonix to 3.5-10 hours. Therefore:
- In normal, healthy individuals, Protonix will be eliminated from the body in as little as 5 to 6 hours.
- In those with liver impairment, it may take 1-2 days for Protonix to be completely eliminated.
- In those with CYP2C19 generic variations, it may take as long as 3 days to eliminate Protonix from the body.
It should be noted that although Protonix is eliminated very quickly in most individuals, the duration of action is still around 24 hours per dose. This is due to how the medication works, as it bonds strongly to sites on the "proton pumps", also known as the (H+,K+)-ATPase enzyme system. This binding results in decreased acid secretion that persists for around 24 hours.
Protonix Gastrointestinal Side Effects
GI (gastrointestinal) side effects are the most frequently reported adverse events with Protonix and the symptoms you mentioned are not uncommon. The most common GI side effects include:
- Nausea
- Abdominal pain
- Vomiting
- Flatulence
- Constipation
If any of the above side effects occur, they generally don't last for more than 24 hours (duration of action of Protonix). In a small number of individuals (e.g. those with liver impairment), the side effects may last longer, taking a few days to resolve.
