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Pantoprazole side effects: what 251,540 FDA adverse event reports show

Pantoprazole · 1,185 reaction terms · 1,376,136 drug–reaction co-reports · data 2026-09-14
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Drug class

Proton pump inhibitor (ppi)

FDA label, Indications wording

Who reports

251,540 reports · 83% serious · 28,518 with death outcome · 58% female

openFDA FAERS counts, all years, deduplication not applied

Used for

Pantoprazole sodium delayed-release tablets are indicated for: Pantoprazole sodium is a proton pump inhibitor (PPI) indicated for the following: Short-Term Treatment of Erosive Esophagitis Associated with Gastroesophageal Reflux Disease (GERD) ( 1.1 ) .

FDA label, Indications and Usage

What it is

Pantoprazole is a member of the class of benzimidazoles that is 1H-benzimidazole substituted by a difluoromethoxy group at position 5 and a [(3,4-dimethoxypyridin-2-yl)methyl]sulfinyl group at position 2.

PubChem CID 4679 (ChEBI)

Boxed warning

None in the current label

How to read this page. FAERS is a spontaneous-reporting system: counts are not incidence rates and a signal is not proof of causation. Each reaction below is run through an automated screen — is the term in the FDA label (known), in the indications (the disease being treated), an administrative/coding term, or none of these (unlabeled)? That screen is mechanical text matching, not a causality assessment. The 30 hand-written Bradford Hill assessments are on the causality assessment page. Not medical advice.

Causality screen of the 40 strongest signals

Labeled (related wording) 4Reporting / coding artifact 1Lab value / disease marker 9Not in label — unassessed 26
What the badges mean

Strongest disproportionality signals

Flagged terms (PRR ≥ 2, χ² ≥ 4, n ≥ 10), ranked by PRR; infinite PRRs (no comparator reports) excluded. The EBGM column is a second, shrinkage-based estimate (MGPS) with its 5th percentile EB05 and the BCPNN IC025; a pair flagged by PRR alone is marked PRR-only and should be read as fragile. The strata column recomputes the PRR on serious reports only (and, for the 300 most-reported drugs, adjusted for age band), and flags pairs whose reports are unusually skewed by sex or come mostly from consumers. Each row also shows the PRR against the other drugs of the same FDA class, which removes most confounding by the condition being treated, and a calibrated p-value: on validation, known non-causes average an ROR of about 2, so significance is judged against that empirical null (✓ = p < 0.05 after calibration). 1,145 further terms are in the interactive explorer. Reaction links open the term's cross-drug page.

Show:
ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Deep vein thrombosis postoperative1,104107.8
98.5–117.9ROR 108.3 · calibrated p 6e-8 ✓
46.9 EB05 44.6 · IC025 +5.4
3/3 methods agree
Not in label — unassessedserious n=1,104 · ♀ 100% (drug 58%) · 92% cliniciannot reported in cached trials
Lupus vulgaris63896.5
86.1–108.2ROR 96.8 · calibrated p 2e-7 ✓
44.6 EB05 41.8 · IC025 +5.3
3/3 methods agree
Not in label — unassessedserious n=638 · ♀ 100% (drug 58%) · 100% cliniciannot reported in cached trials
C-reactive protein46788.4
77.6–100.8ROR 88.6 · calibrated p 3e-7 ✓
42.8 EB05 39.6 · IC025 +5.2
3/3 methods agree
Lab value / disease markerserious n=466 · ♀ 100% (drug 58%) · 100% cliniciannot reported in cached trials
Swollen joint count increased1,50777.9
72.6–83.6ROR 78.3 · calibrated p 7e-7 ✓
40.2 EB05 38.6 · IC025 +5.2
3/3 methods agree
Lab value / disease markerserious n=1,506 · ♀ 100% (drug 58%) · 100% cliniciannot reported in cached trials
Anti-cyclic citrullinated peptide antibody32076.7
65.8–89.3ROR 76.8 · calibrated p 9e-7 ✓
39.8 EB05 36.3 · IC025 +5.0
3/3 methods agree
Lab value / disease markerserious n=320 · ♀ 100% (drug 58%) · 100% cliniciannot reported in cached trials
Anti-cyclic citrullinated peptide antibody positive3,01061.1
58.2–64.0ROR 61.8 · calibrated p 3e-6 ✓
35.3 EB05 34.2 · IC025 +5.1
3/3 methods agree
Lab value / disease markerserious PRR 24.4 · ♀ 100% (drug 58%) · 94% cliniciannot reported in cached trials
Adjustment disorder with depressed mood85360.9
55.8–66.6ROR 61.1 · calibrated p 4e-6 ✓
35.2 EB05 33.3 · IC025 +5.0
3/3 methods agree
Not in label — unassessedserious n=852 · ♀ 100% (drug 58%) · 100% cliniciannot reported in cached trials
Duodenal ulcer perforation3,06459.5
56.8–62.3ROR 60.2 · calibrated p 4e-6 ✓
34.8 EB05 33.7 · IC025 +5.1
3/3 methods agree
Not in label — unassessedserious PRR 24.0 · ♀ 100% (drug 58%) · 93% cliniciannot reported in cached trials
Rheumatic fever1,78057.1
53.8–60.7ROR 57.5 · calibrated p 6e-6 ✓
33.9 EB05 32.6 · IC025 +5.0
3/3 methods agree
Not in label — unassessedserious n=1,779 · ♀ 100% (drug 58%) · 95% cliniciannot reported in cached trials
X-ray abnormal69953.4
48.6–58.8ROR 53.6 · calibrated p 9e-6 ✓
32.6 EB05 30.6 · IC025 +4.9
3/3 methods agree
Lab value / disease markerserious n=699 · ♀ 100% (drug 58%) · 100% cliniciannot reported in cached trials
Muscle injury3,15651.8
49.6–54.2ROR 52.5 · calibrated p 1e-5 ✓
32.0 EB05 31.1 · IC025 +4.9
3/3 methods agree
Not in label — unassessedserious PRR 23.9 · ♀ 100% (drug 58%) · 93% cliniciannot reported in cached trials
Dislocation of vertebra82749.1
45.0–53.5ROR 49.2 · calibrated p 2e-5 ✓
30.9 EB05 29.2 · IC025 +4.8
3/3 methods agree
Not in label — unassessedserious n=827 · ♀ 100% (drug 58%) · 93% cliniciannot reported in cached trials
Facet joint syndrome1,15948.2
44.8–51.8ROR 48.4 · calibrated p 2e-5 ✓
30.6 EB05 29.2 · IC025 +4.8
3/3 methods agree
Not in label — unassessedserious n=1,158 · ♀ 100% (drug 58%) · 94% cliniciannot reported in cached trials
Rheumatoid factor positive1,94942.3
40.0–44.6ROR 42.6 · calibrated p 4e-5 ✓
28.1 EB05 27.1 · IC025 +4.7
3/3 methods agree
Lab value / disease markerserious n=1,949 · ♀ 100% (drug 58%) · 96% cliniciannot reported in cached trials
Folliculitis3,32439.3
37.7–41.0ROR 39.8 · calibrated p 5e-5 ✓
26.8 EB05 26.1 · IC025 +4.7
3/3 methods agree
Not in label — unassessedserious PRR 21.7 · ♀ 100% (drug 58%) · 93% cliniciannot reported in cached trials
Helicobacter infection3,25938.9
37.3–40.6ROR 39.4 · calibrated p 6e-5 ✓
26.6 EB05 25.9 · IC025 +4.7
3/3 methods agree
Not in label — unassessedserious PRR 19.4 · ♀ 100% (drug 58%) · 92% cliniciannot reported in cached trials
Retinitis53138.6
34.8–42.8ROR 38.7 · calibrated p 7e-5 ✓
26.5 EB05 24.6 · IC025 +4.6
3/3 methods agree
Not in label — unassessedserious n=531 · ♀ 100% (drug 58%) · 100% cliniciannot reported in cached trials
Pemphigus3,88537.6
36.2–39.1ROR 38.2 · calibrated p 7e-5 ✓
26.0 EB05 25.4 · IC025 +4.6
3/3 methods agree
Not in label — unassessedserious PRR 18.0 · ♀ 100% (drug 58%) · 94% cliniciannot reported in cached trials
Peripheral venous disease1,14133.1
30.9–35.4ROR 33.2 · calibrated p 2e-4 ✓
23.8 EB05 22.7 · IC025 +4.5
3/3 methods agree
Not in label — unassessedserious n=1,135 · ♀ 100% (drug 58%) · 94% cliniciannot reported in cached trials
Hand deformity3,55130.8
29.6–32.0ROR 31.2 · calibrated p 2e-4 ✓
22.6 EB05 22.0 · IC025 +4.4
3/3 methods agree
Not in label — unassessedserious PRR 17.0 · ♀ 100% (drug 58%) · 92% cliniciannot reported in cached trials
Hypertensive nephropathy27728.6
24.9–32.7ROR 28.6 · calibrated p 4e-4 ✓
21.4 EB05 19.3 · IC025 +4.2
3/3 methods agree
Not in label — unassessedserious n=277 · 100% consumernot reported in cached trials
Blood pressure diastolic abnormal63827.3
25.0–29.8ROR 27.4 · calibrated p 4e-4 ✓
20.7 EB05 19.4 · IC025 +4.2
3/3 methods agree
Lab value / disease markerserious n=613 · 90% cliniciannot reported in cached trials
Blood pressure systolic abnormal56924.5
22.3–26.9ROR 24.5 · calibrated p 8e-4 ✓
19.0 EB05 17.7 · IC025 +4.1
3/3 methods agree
Lab value / disease markerserious n=546 · 100% cliniciannot reported in cached trials
Pericarditis3,63023.0
22.2–23.9ROR 23.3 · calibrated p 9e-4 ✓
18.1 EB05 17.7 · IC025 +4.1
3/3 methods agree
Not in label — unassessedserious PRR 12.6 · ♀ 96% (drug 58%) · 92% cliniciannot reported in cached trials
Porphyria acute29822.7
20.0–25.8ROR 22.8 · calibrated p 0.001 ✓
18.0 EB05 16.3 · IC025 +3.9
3/3 methods agree
Not in label — unassessedserious n=298 · ♀ 100% (drug 58%) · 100% cliniciannot reported in cached trials
Synovitis3,83322.3
21.5–23.1ROR 22.6 · calibrated p 0.001 ✓
17.7 EB05 17.2 · IC025 +4.1
3/3 methods agree
Not in label — unassessedserious PRR 12.8 · ♀ 100% (drug 58%) · 93% cliniciannot reported in cached trials
C-reactive protein abnormal1,35522.2
20.9–23.5ROR 22.3 · calibrated p 0.001 ✓
17.6 EB05 16.8 · IC025 +4.0
3/3 methods agree
Lab value / disease markerserious n=1,347 · ♀ 100% (drug 58%) · 94% cliniciannot reported in cached trials
Seronegative arthritis22520.7
17.9–24.0ROR 20.7 · calibrated p 0.002 ✓
16.7 EB05 14.9 · IC025 +3.8
3/3 methods agree
Not in label — unassessedserious n=225 · ♀ 100% (drug 58%) · 100% cliniciannot reported in cached trials
Bone erosion69320.1
18.5–21.8ROR 20.1 · calibrated p 0.002 ✓
16.3 EB05 15.3 · IC025 +3.9
3/3 methods agree
Not in label — unassessedserious n=691 · ♀ 100% (drug 58%) · 90% cliniciannot reported in cached trials
Drug tolerance decreased51118.4
16.7–20.3ROR 18.5 · calibrated p 0.003 ✓
15.2 EB05 14.1 · IC025 +3.8
3/3 methods agree
Not in label — unassessedserious n=498 · ♀ 100% (drug 58%)not reported in cached trials
Product monitoring error25718.0
15.7–20.6ROR 18.0 · calibrated p 0.003 ✓
14.9 EB05 13.4 · IC025 +3.7
3/3 methods agree
Reporting / coding artifactserious n=257 · 100% cliniciannot reported in cached trials
Nephrogenic anaemia83517.9
16.7–19.3ROR 18.0 · calibrated p 0.003 ✓
14.9 EB05 14.0 · IC025 +3.8
3/3 methods agree
Not in label — unassessedserious n=834 · 100% consumernot reported in cached trials
Adjustment disorder23117.8
15.4–20.5ROR 17.8 · calibrated p 0.004 ✓
14.7 EB05 13.2 · IC025 +3.6
3/3 methods agree
Not in label — unassessedserious n=230 · ♀ 100% (drug 58%) · 100% cliniciannot reported in cached trials
Temperature regulation disorder38317.5
15.7–19.6ROR 17.6 · calibrated p 0.004 ✓
14.6 EB05 13.4 · IC025 +3.7
3/3 methods agree
Not in label — unassessedserious n=383 · ♀ 100% (drug 58%) · 100% cliniciannot reported in cached trials
Irritable bowel syndrome3,65217.0
16.4–17.6ROR 17.3 · calibrated p 0.004 ✓
14.2 EB05 13.9 · IC025 +3.8
3/3 methods agree
Not in label — unassessedserious PRR 12.3 · ♀ 100% (drug 58%)not reported in cached trials
End stage renal disease2,89715.4
14.8–16.0ROR 15.6 · calibrated p 0.006 ✓
13.1 EB05 12.7 · IC025 +3.6
3/3 methods agree
Not in label — unassessedserious PRR 9.0not reported in cached trials

Clinical concept groups

MedDRA splits one clinical problem across several terms (e.g. "neutropenia", "neutrophil count decreased", "agranulocytosis"), which dilutes term-level signals. These rows count reports with any term in a concept group (an exact union, not a sum), compared with all other drugs. Groups are hand-built and listed in the methods.

ConceptReportsPRR 95% CIReading
Kidney injury20,4993.93.8–3.9signal
Hyponatraemia3,5733.83.7–4.0signal
Liver injury11,7553.33.3–3.4signal
Interstitial lung disease3,7203.33.2–3.4signal
Gi bleeding6,6263.13.0–3.2signal
Anaemia10,7883.13.0–3.1signal
Severe cutaneous reaction2,4152.82.7–2.9signal
Serious infection24,1022.72.6–2.7signal
Arrhythmia / qt5,6562.52.4–2.5signal
Neutropenia / agranulocytosis7,2272.52.4–2.5signal
Pancreatitis2,3482.52.4–2.6signal
Rhabdomyolysis / myopathy2,2732.42.3–2.5signal
Thrombocytopenia6,0072.32.3–2.4signal
Fall / fracture9,4432.12.1–2.1signal
Heart failure4,3652.12.0–2.1raised
Venous thromboembolism4,6581.81.8–1.9raised

Trial evidence (ClinicalTrials.gov)

✓ Trial adverse-event data found on ClinicalTrials.gov

Largest completed trials with posted results that list Pantoprazole as a study intervention. The right-hand column of the signal table shows whether each FAERS term was also recorded in these trials, with a real denominator (0 of 40 signal terms matched).

Caveats: trial populations, doses and follow-up differ from the reporting population; AE terms are sponsor-coded and matched here by wording; absence from a trial list means the term was not reported above the sponsor's frequency threshold, not that it cannot occur.

Most frequently reported reactions

By raw co-report count, regardless of disproportionality. Common terms here are often the illness itself or generic outcomes.

ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Fatigue (tiredness)20,7732.3
2.2–2.3ROR 2.4 · calibrated p 0.868
2.2 EB05 2.2 · IC025 +1.1
3/3 methods agree
Labeled adverse reaction
exact term
age-adj. PRR 1.9 · serious PRR 2.4not reported in cached trials
Off label use (used outside approved label)18,6231.8
1.8–1.8ROR 1.9 · calibrated p 0.871
1.8 EB05 1.8 · IC025 +0.8Reporting / coding artifactage-adj. PRR 1.7 · serious PRR 2.0not reported in cached trials
Nausea17,8561.9
1.9–1.9ROR 2.0 · calibrated p 0.931
1.9 EB05 1.9 · IC025 +0.9Labeled adverse reaction
exact term
age-adj. PRR 1.8 · serious PRR 2.1not reported in cached trials
Diarrhoea (diarrhea)17,5562.3
2.3–2.3ROR 2.4 · calibrated p 0.853
2.3 EB05 2.2 · IC025 +1.2
3/3 methods agree
Labeled adverse reaction
exact term
age-adj. PRR 2.0 · serious PRR 2.3not reported in cached trials
Dyspnoea (shortness of breath)17,2892.6
2.6–2.6ROR 2.7 · calibrated p 0.727
2.5 EB05 2.5 · IC025 +1.3
3/3 methods agree
Not in label — unassessedage-adj. PRR 2.2 · serious PRR 2.2not reported in cached trials
Drug ineffective (drug did not work)17,2041.1
1.1–1.1ROR 1.1 · calibrated p 0.370
1.1 EB05 1.1 · IC025 +0.1Reporting / coding artifactage-adj. PRR 1.2 · serious PRR 1.7not reported in cached trials
Pain15,5282.1
2.1–2.2ROR 2.2 · calibrated p 0.948
2.1 EB05 2.1 · IC025 +1.0
3/3 methods agree
Labeled adverse reaction
exact term
age-adj. PRR 2.1 · serious PRR 2.1 · ♀ 79% (drug 58%)NCT00562094: 1/8,616 (0.0%) on Pantoprazole
Headache13,3241.8
1.8–1.8ROR 1.8 · calibrated p 0.850
1.8 EB05 1.7 · IC025 +0.8Labeled adverse reaction
exact term
age-adj. PRR 1.7 · serious PRR 2.1 · ♀ 79% (drug 58%)not reported in cached trials
Vomiting12,7802.3
2.3–2.3ROR 2.4 · calibrated p 0.867
2.3 EB05 2.2 · IC025 +1.2
3/3 methods agree
Labeled adverse reaction
exact term
age-adj. PRR 2.1 · serious PRR 2.1not reported in cached trials
Arthralgia (joint pain)12,2612.5
2.5–2.6ROR 2.6 · calibrated p 0.776
2.5 EB05 2.4 · IC025 +1.3
3/3 methods agree
Labeled adverse reaction
exact term
age-adj. PRR 2.1 · serious PRR 2.8 · ♀ 80% (drug 58%)NCT00562094: 1/8,616 (0.0%) on Pantoprazole
Pyrexia (fever)11,5942.9
2.8–2.9ROR 2.9 · calibrated p 0.645
2.8 EB05 2.7 · IC025 +1.4
3/3 methods agree
Labeled adverse reaction
exact term
age-adj. PRR 2.5 · serious PRR 2.3not reported in cached trials
Acute kidney injury (sudden kidney damage)11,5486.8
6.6–6.9ROR 7.0 · calibrated p 0.097
6.3 EB05 6.2 · IC025 +2.6
3/3 methods agree
Not in label — unassessedage-adj. PRR 4.1 · serious PRR 4.4not reported in cached trials
Asthenia (weakness)11,4352.6
2.5–2.6ROR 2.7 · calibrated p 0.748
2.5 EB05 2.5 · IC025 +1.3
3/3 methods agree
Labeled adverse reaction
exact term
age-adj. PRR 2.1 · serious PRR 2.3not reported in cached trials
Dizziness10,9001.8
1.8–1.9ROR 1.9 · calibrated p 0.877
1.8 EB05 1.8 · IC025 +0.8Labeled adverse reaction
exact term
age-adj. PRR 1.6 · serious PRR 1.9NCT00562094: 1/8,616 (0.0%) on Pantoprazole

Unlabeled candidate signals

These flagged terms were not found in the FDA label text and do not match an artifact pattern. They are the pairs that would merit a structured assessment (temporality, dose-response, biological plausibility, consistency across databases, trial or cohort evidence). The screen has not done that; string-matching misses label wording, and a strong PRR can still be stimulated reporting, co-medication, or the disease itself.

Want to assess one of these properly? The runbook describes the Bradford Hill / trial-evidence workflow used on the assessment page, and handoff_top1000_signals.csv lists the strongest unassessed pairs across all drugs.

Common questions

What are the most reported side effects of Pantoprazole?

In FDA FAERS, the most frequently co-reported reaction terms for Pantoprazole are fatigue, nausea, diarrhoea, dyspnoea, pain, headache. These are report counts, not rates: FAERS has no denominator, reporting is voluntary and uneven, and a term can be reported because of the illness being treated rather than the drug.

Does Pantoprazole have an FDA boxed warning?

No. The FDA label retrieved for Pantoprazole has no boxed warning; see the label's Warnings and Precautions for the recognised risks.

Do FAERS signals prove that Pantoprazole causes these side effects?

No. A disproportionality signal (PRR, ROR) means a reaction is reported more often with this drug than with others in the database. That can reflect a real effect, but also the disease being treated, stimulated reporting after news or litigation, co-medications, or how reports are coded. Causality needs temporality, dose-response, biological plausibility, consistency across data sources and, ideally, trial or cohort evidence. This page screens each term against the FDA label and ClinicalTrials.gov results; it does not establish causation.

Sources & methods

Page generated 2026-10-14. Label and PubChem text are retrieved automatically and may lag the current label; always check the current prescribing information. OpenPV is a beta research tool of the Open Source Medicine Foundation.