When taking Pantoprazole 40mg tablets, the doctor’s instructions should always be followed exactly.  The usual dose is one tablet per day but your doctor will tell you how many tablets to take, how long to take them for.  The tablet should be taken one hour before food and it should be swallowed whole with water.  

Each tablet contains the active ingredient 40mg pantoprazole (as pantoprazole sodium sesquihydrate). 

They also contain calcium stearate, cellulose microcrystalline, crospovidone, hydroxypropylcellulose (type EXF), sodium carbonate, anhydrous, silica, colloidal anhydrous, hypromellose, iron oxide yellow (E172), macrogol 400, methacrylic acid – ethyl acrylate copolymer (1:1) polysorbate 80,  ponceau 4R aluminium lake (E124), quinoline yellow aluminium lake (E104), sodium lauryl sulphate, titanium dioxide (E171), triethyl citrate.

If you are allergic to any of the ingredients of pantoprazole 40mg tablets or medicines containing any proton pump inhibitors, or taking medicine with which pantoprazole may influence the effectiveness of, or if you are at all unsure, speak to your doctor before taking these tablets.  If you are taking any medication at all including non-prescription medication, tell you doctor before taking Pantoprazole 40mg tablets.
If you lose a lot of weight for no reason, get stomach pain or indigestion, repeated vomiting, vomiting blood, have problems swallowing, look pale and feel weak, notice blood stained stools, have severe liver problems, have severe or persistent diarrhoea, then talk to your doctor straight away.
Pantoprazole 40mg tablets can, like any medication, cause side effects though not everyone will be affected. The following side effects are rare but potentially serious and if any of them are noticed, stop taking Pantoprazole 40mg tablets and immediately contact your doctor.  If you have had any liver problems or if you have reduced body stores or risk factors for reduced vitamin B12.  If you take any medicine containing atazanavir (used for the treatment of HIV-infection) ask your doctor for advice.  Pantoprazole also alleviates the symptoms of cancer and could cause delay in diagnosing it, so if your symptoms continue in spite of treatment, ask your doctor for advice.  Your doctor will monitor you regularly if you take Pantoprazole 40mg for a term, longer than one year.
Pantoprazole may influence the effectiveness of other medicines so tell your doctor if you are taking ketoconazole, itrazonazole, posaconazole, erlotinib, Warfarin, phenprocoumon, or Methotrexate.  If you are planning to have a baby, think you may be pregnant or breast-feeding, ask your doctor for advice before taking Pantoprazole.  If you experience side effects like dizziness or disturbed vision, you should not drive or operate machines. 
If you notice any of the following side effects, stop taking these tablets and tell your doctor immediately: serious allergic reactions such as swelling of the tongue/throat/face, difficulty in swallowing, breathing, hives, dizziness with very fast heartbeat and heavy sweating.  Serious skin conditions such as blistering of the skin and rapid deterioration of your general condition, bleeding of eyes, nose, mouth, lips or genitals, or sensitivity to light.  Yellowing of the skin or whites of the eyes, fever, rash or enlarged kidneys, feeling weak, exhausted or generally unwell, or sleeping disorders may also be experienced.  Taking Pantoprazole 40mg or any other proton pump inhibitor especially over a period of more than one year may slightly increase the risk of fracture in the wrist, hip or spine. 
Tell your doctor if you are taking corticosteroids or if you have osteoporosis. If you experience distortion of complete lack of taste, blurred vision, pain in the joints, muscle pains, raised temperature, depression, or breast enlargement in males, disorientation, hallucinations, confusion or decreased sodium levels in the blood.  If Pantoprazole 40mg is taken for more than three months there is a possibility that the levels of magnesium in the blood may fall and this may be seen as fatigue, disorientation, involuntary muscle contractions, dizziness, convulsions, or increased heart rate. Low levels of magnesium can also lead to a reduction in potassium or calcium levels in the blood and your doctor may decide to monitor your blood to check the levels. 
Rare side effects may be an increase in liver enzymes, bilirubin, increased fats in the blood, a sharp drop in circulating granular white blood cells which is associated with high fever.  A reduction in the number of blood platelets which may cause bleeding or bruising more than is normal, coexisting abnormal reduction in the number of red and white blood cells.  Any side effects at all, even those not listed, must be reported to your doctor or pharmacist as soon as possible.