From the Guidelines
Pantoprazole can cause pancreatitis, although the causality has not been established, and it is recommended to discontinue the medication if pancreatitis is suspected. Pantoprazole, a proton pump inhibitor (PPI), is commonly used to reduce stomach acid production for conditions like gastroesophageal reflux disease (GERD) and peptic ulcers. According to a recent study published in 2025 1, pancreatitis has been reported in clinical trials, but the exact mechanism and frequency of this side effect are not well understood. The study suggests that patients with kidney disease should be cautious when initiating or increasing the dose of pantoprazole due to the increased risk of gastrointestinal side effects and potential risk of acute kidney injury from dehydration.
- Key points to consider when prescribing pantoprazole include:
- Monitoring for signs and symptoms of pancreatitis, such as severe upper abdominal pain radiating to the back, nausea, vomiting, or elevated pancreatic enzymes
- Discontinuing the medication if pancreatitis is suspected
- Using caution in patients with kidney disease or other underlying health conditions
- Informing patients about the potential risk of pancreatitis and the importance of seeking medical attention if symptoms occur. As noted in the study 1, possible safety concerns and considerations for pantoprazole include rare cases of severe liver injury and caution with cardiovascular disease, highlighting the need for careful patient selection and monitoring.
From the Research
Pantoprazole and Pancreatitis
- Pantoprazole, a proton pump inhibitor (PPI), has been reported to cause acute pancreatitis in rare cases 2.
- A case report published in 2012 described an 11-year-old boy who developed acute pancreatitis after taking oral pantoprazole for gastroesophageal reflux disease 2.
- The Naranjo adverse drug reaction probability scale suggested that the likelihood of pantoprazole being responsible for the acute pancreatitis was 'probable' 2.
Comparison with Other Proton Pump Inhibitors
- Another study reported a case of acute pancreatitis associated with omeprazole, another PPI 3.
- A systematic review found that metronidazole-induced pancreatitis may be potentiated by concurrent use of omeprazole, a PPI 4.
- However, pantoprazole has been shown to have a pancreatic anti-secretory effect and inhibitory reactivity towards hydroxyl radicals, which may be beneficial in acute pancreatitis 5.
Clinical Studies
- A pilot study investigated the effect of pantoprazole on the course of acute pancreatitis and found no significant differences in clinical outcomes between patients who received pantoprazole and those who did not 5.
- The study suggested that large-scale prospective trials are needed to confirm the findings 5.
- Pantoprazole has been shown to be effective and well-tolerated in the treatment of acid-related disorders, including gastroesophageal reflux disease and NSAID-related gastric and gastroduodenal injury 6.