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Pan-D side effects: common and serious

Also in: हिन्दी தமிழ் मराठी తెలుగు ಕನ್ನಡ বাংলা ગુજરાતી മലയാളം

Also known as: Pan D, Pan D capsule, PanD

Most people take Pan-D without problems, and side effects are usually mild. The rare but serious risk is a heart rhythm problem caused by domperidone.

Pan-D: Uses, How It Works, Side Effects

Active ingredient
Pantoprazole 40 mg + Domperidone 30 mg
Type of medicine
Proton pump inhibitors (PPIs), Prokinetics
Used for
Acidity and acid reflux
Starts working in
Domperidone within a few hours; acid symptoms often ease in 2 to 3 days
Effect lasts
About 24 hours per dose
With or without food
Usually once a day before breakfast
Alcohol
Best avoided; it can worsen reflux and some side effects
Pregnancy
Ask your doctor
Habit-forming
No
Made by
Alkem Laboratories Ltd

Pharmacist review in progress. This page is based on the sources listed below and is being checked by our registered pharmacist.

On this page
  1. Side effects of Pan-D
  2. Who should be careful
  3. If someone takes too much
  4. Common questions

Side effects of Pan-D

Most people take Pan-D without problems, and side effects are usually mild. The rare but serious risk is a heart rhythm problem caused by domperidone.

Uncommon or mild

  • Headache
  • Diarrhoea
  • Feeling sick (nausea) or stomach pain
  • Wind (gas)
  • Dizziness
  • Dry mouth

Rare but serious: get medical help

  • A fast, pounding or irregular heartbeat, fainting, or feeling faint. Get medical help immediately, as this can be a sign of a dangerous heart rhythm problem
  • Fits (seizures)
  • Uncontrolled movements, such as muscle spasms, a twisted neck or eyes rolling upwards
  • Breast swelling or tenderness, milk coming from the nipples, or missed periods, which are signs of a raised prolactin hormone. Tell your doctor
  • Signs of a severe allergic reaction: swelling of the face, lips or throat, difficulty breathing, or a sudden widespread rash
  • A serious skin reaction: red skin with blisters or peeling, sores in the mouth, or a widespread rash with fever. Stop the medicine and get medical help immediately
  • Watery or bloody diarrhoea that does not go away, with stomach cramps or fever, which can be a sign of a gut infection called C. difficile
  • Passing less urine, blood in the urine, fever, rash or pain in the lower back, which can be signs of kidney inflammation
  • Yellowing of the skin or eyes, dark urine, or stomach pain that gets worse, which can be signs of liver problems
  • Muscle cramps or twitching, shaking, an irregular heartbeat or unusual tiredness, which can be signs of low magnesium after several months of use

Who should be careful

Some people should not take Pan-D or need to check with a doctor first, mainly because of domperidone's effect on the heart and pantoprazole's long-term effects.

  • Heart disease, heart failure, an irregular heartbeat, or a known long QT interval on an ECG (heart tracing): European regulators say domperidone should not be used
  • Age over 60: the risk of heart rhythm problems with domperidone is higher
  • Low potassium or magnesium in the blood, for example from vomiting, diarrhoea or water tablets (diuretics)
  • Liver disease: domperidone is broken down by the liver and should not be used in moderate or severe liver disease
  • Serious kidney disease: domperidone may need to be taken less often, so the doctor may choose another medicine
  • Bleeding from the stomach or gut, or a blockage or tear in the gut
  • A pituitary tumour that releases prolactin (prolactinoma)
  • Warning signs that need a doctor's check first: unexplained weight loss, difficulty or pain when swallowing, repeated vomiting, vomiting blood, or black stools. Pantoprazole can ease symptoms and hide a more serious problem
  • Long-term use: pantoprazole can lower vitamin B12 and magnesium and slightly raise the risk of bone fractures and gut infections
  • Pregnancy: information is limited, so ask your doctor
  • Breastfeeding: Indian product information says breastfeeding is not recommended while taking domperidone
  • Past allergic reaction to pantoprazole, similar medicines such as omeprazole, or domperidone

If someone takes too much

Too much domperidone can cause drowsiness, confusion, uncontrolled movements and, in some cases, heart rhythm problems, especially in children. There is no specific antidote; treatment supports the body and monitors the heart. If someone has taken more than prescribed, call 112 or go to the nearest hospital and take the medicine pack with you.

Common questions

Is Pan-D safe for the heart?

For most people the risk is small, but domperidone can rarely cause a dangerous heart rhythm problem. The risk is higher in people over 60, people with heart disease, and people taking certain antibiotics, antifungals or heart medicines. Get help immediately for a fast or irregular heartbeat or fainting.

Can I take Pan-D for a long time?

Only if your doctor advises it and reviews it regularly. Domperidone is meant to be used at the lowest dose for the shortest time, and long-term pantoprazole use is linked to low vitamin B12 and magnesium, fractures and gut infections. Do not continue it for months on your own.

Is Pan-D habit-forming?

No. It is not addictive. After several weeks of use, stomach acid can briefly rise when pantoprazole is stopped, so symptoms may return for a while. Talk to your doctor about how and when to stop.

Sources

  1. PAN-D (pantoprazole enteric-coated and domperidone sustained-release capsules): prescribing information (revised September 2019). Alkem Laboratories Ltd
  2. CMDh confirms recommendations on restricting use of domperidone-containing medicines. European Medicines Agency
  3. Domperidone 1 mg/ml Oral Suspension: Summary of Product Characteristics. electronic medicines compendium (emc), UK
  4. PROTONIX (pantoprazole sodium) delayed-release tablets: full prescribing information (revised 6/2023). Pfizer (Wyeth Pharmaceuticals), US FDA-approved labeling
  5. Pantoprazole. StatPearls, National Center for Biotechnology Information (NCBI), US National Library of Medicine
  6. Common questions about domperidone. NHS (UK)
  7. Side effects of domperidone. NHS (UK)
  8. Who can and cannot take domperidone. NHS (UK)
  9. Pantoprazole: medicine to lower stomach acid. NHS (UK)
  10. FIXED DOSE COMBINATIONS APPROVED BY DCG (I) SINCE 1961 to 28th JUNE 2019. Central Drugs Standard Control Organisation (CDSCO)
  11. List of drugs prohibited for manufacture and sale through gazette notifications under section 26A of the Drugs & Cosmetics Act 1940. Central Drugs Standard Control Organisation (CDSCO)
  12. Fixed Dose Combinations (including list of 156 prohibited FDCs dated 02.08.2024). Central Drugs Standard Control Organisation (CDSCO)
  13. National Formulary of India. Indian Pharmacopoeia Commission