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INTERACTION
Pantoprazole CAS number 102625-70-7
Pantoprazole is metabolized through the cytochrome P450 system,
primarily the CYP2C19 and to a minor extent the CYP3A4 isozymes, and
subsequently undergoes Phase II conjugation Based on studies evaluating
possible interactions of pantoprazole with other drugs, no dosage adjustment
is needed with concomitant use of the following: theophylline, cisapride,
antipyrine, caffeine, carbamazepine, diazepam , diclofenac, naproxen,
piroxicam, digoxin, ethanol, glyburide, an oral contraceptive , metoprolol,
nifedipine, phenytoin, warfarin , midazolam, clarithromycin, metronidazole,
or amoxicillin. Clinically relevant interactions of pantoprazole with other
drugs with the same metabolic pathways are not expected. Therefore, when
coadministered with pantoprazole, adjustment of the dosage of pantoprazole
or of such drugs may not be necessary. There was also no interaction with
concomitantly administered antacids. There have been postmarketing reports
of increased INR and prothrombin time in patients receiving proton pump
inhibitors, including pantoprazole, and warfarin concomitantly. Increases in
INR and prothrombin time may lead to abnormal bleeding and even death.
Patients treated with proton pump inhibitors and warfarin concomitantly
should be monitored for increases in INR and prothrombin time.
Concomitant use of atazanavir and proton pump inhibitors is not recommended.
Coadministration of atazanavir with proton pump inhibitors is expected to
substantially decrease atazanavir plasma concentrations and thereby reduce
its therapeutic effect.
Because of profound and long lasting inhibition of gastric acid secretion,
pantoprazole may interfere with absorption of drugs where gastric pH is an
important determinant of their bioavailability (eg, ketoconazole, ampicillin
esters, and iron salts).
This drug should not be used with the following medications because a very
serious interaction may occur: atazanavir, nelfinavir.
If you are currently using either of these medications, tell your doctor or
pharmacist before starting pantoprazole.
Before using this medication, tell your doctor or pharmacist of all
prescription and nonprescription/herbal products you may use, especially of:
warfarin.
Some products need stomach acid so that the body can absorb them properly
(such as ampicillin, iron supplements, calcium supplements, dasatinib, azole
antifungals including ketoconazole). Pantoprazole decreases stomach acid, so
it may change how well these other products work. Before using pantoprazole,
consult your doctor or pharmacist about the other medications you take and
for advice on how to reduce or avoid these types of interactions.
This medication may affect the results of certain lab tests (e.g., urine
test for tetrahydrocannabinol-THC). Make sure laboratory personnel and your
doctors know you use this drug.
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