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Pantoprazole is not removed by hemodialysisIn case of overdosetreatment should be symptomatic and supportive.

Literature suggests that concomitant use of PPIs with methotrexateprimarily at high dosesee methotrexate prescribing informationmay elevate and prolong serum levels of methotrexate and/or its metabolitepossibly leading to methotrexate toxicitiesIn high-dose methotrexate administrationa temporary withdrawal of the PPI may be considered in some patientssee Drug Interactions7

In vivo studies also suggest that pantoprazole does not significantly affect the kinetics of other drugscisapridetheophyllinediazepamand its active metabolitedesmethyldiazepamphenytoinmetoprololnifedipinecarbamazepinemidazolamclarithromycindiclofenacnaproxenpiroxicam and oral contraceptiveslevonorgestrel/ethinyl estradiolIn other in vivo studiesdigoxinethanolglyburideantipyrinecaffeinemetronidazoleand amoxicillin had no clinically relevant interactions with pantoprazole.

Hematologicleukopeniareported in ex-US clinical trials onlythrombocytopenia.

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