Pantoprazole Mode of Action
Pantoprazole is a PPI that suppresses the final step in gastric acid production by covalently binding to the (H+, K+)-ATPase enzyme system at the secretory surface of the gastric parietal cell. This effect leads to inhibition of both basal and stimulated gastric acid secretion, irrespective of the stimulus. The binding to the (H+, K+)-ATPase results in a duration of antisecretory effect that persists longer than 24 hours for all doses tested
Brands of Pantoprazole in Kenya
Luganor®, Arwan Pharmaceutical Industries Lebanon s.a.l
Pan® ,Alkem Laboratories
Pandev® , Pharmaco Healthcare Limited
Panopaz® ,Aglowmed Limited
Panpure® , Emcure Pharmaceuticals Ltd
Pansalve®, Emcure Pharmaceuticals Ltd
Pantakind® ,Mankind Pharma Ltd
Pantaz® , Medley Pharmaceuticals Limited
Pantin®, Hetero Labs Limited
Panto® , Dawa Limited
Pantocid® , Sun Pharmaceutical Industries Limited
Panto-Denk® , Denk Pharma Gmbh & Co. Kg
Pantoloc® , Takeda (Pty) Ltd.
Pantonex®, IPCA Laboratories Limited
Pantor®, Torrent Pharmaceuticals Ltd
Pantotab®, Micro Labs Ltd
Pantozed® , Zawadi Healthcare Ltd
Pantro® ,Brawn Laboratories Ltd.
Pentalink® , Lincoln Pharmaceuticals Ltd
Pasopan® , Psa International
Reprat® , Delorbis Pharmaceuticals Limited
Topraz® , Aurobindo Pharma Ltd
Trupan®, Square Pharmaceuticals Ltd.
Ultop® , Leben Laboratories PVT Ltd
Pantoprazole is a proton pump inhibitor (PPI) indicated for the following:
- Short-Term Treatment of Erosive Esophagitis Associated with Gastroesophageal Reflux Disease (GERD).
- Maintenance of Healing of Erosive Esophagitis.
- Pathological Hypersecretory Conditions Including Zollinger-Ellison (ZE) Syndrome.
Pantoprazole is contraindicated in patients with known hypersensitivity to any component of the formulation or any substituted benzimidazole. Hypersensitivity reactions may include anaphylaxis, anaphylactic shock, angioedema, bronchospasm, acute interstitial nephritis, and urticaria
Proton pump inhibitors (PPIs), including pantoprazole sodium, are contraindicated with rilpivirine-containing products
ADVERSE DRUG REACTIONS:
The following serious adverse reactions have been reported:
- Acute Interstitial Nephritis
- Clostridium difficile-Associated Diarrhea
- Bone Fracture
- Cutaneous and Systemic Lupus Erythematosus
- Cyanocobalamin (Vitamin B-12) Deficiency
- Fundic Gland Polyps
Medicinal products with pH-Dependent Absorption Pharmacokinetics
Because of profound and long lasting inhibition of gastric acid secretion, pantoprazole may interfere with the absorption of other medicinal products where gastric is an important determinant of oral availability e.g some azole antifungals as ketoconazole, itraconazole, posaconazole and other medicine as erlotinib.
HIV protease inhibitors
Co-administration of pantoprazole is not recommended with HIV protease inhibitors for which absorption is dependent on acidic intragastric pH such as atazanavir due to significant reduction in their bioavailability
If the combination of HIV protease inhibitors with a proton pump inhibitor is judged unavoidable, close clinical monitoring (e.g. virus load) is recommended. A pantoprazole dose of 20 mg per day should not be exceeded. Dosage of the HIV protease inhibitor may need to be adjusted
Coumarin anticoagulants (phenprocoumon or warfarin)
Co-administration of pantoprazole with warfarin or phenprocoumon did not affect the pharmacokinetics of warfarin, phenprocoumon or INR. However, there have been reports of increased INR and prothrombin time in patients receiving PPIs and warfarin or phenprocoumon concomitantly. Increases in INR and prothrombin time may lead to abnormal bleeding, and even death. Patients treated with pantoprazole and warfarin or phenprocoumon may need to be monitored for increase in INR and prothrombin time.
Concomitant use of high dose methotrexate (e.g. 300 mg) and proton-pump inhibitors has been reported to increase methotrexate levels in some patients. Therefore in settings where high-dose methotrexate is used, for example cancer and psoriasis, a temporary withdrawal of pantoprazole may need to be considered.
Other interactions studies
Pantoprazole is extensively metabolized in the liver via the cytochrome P450 enzyme system. The main metabolic pathway is demethylation by CYP2C19 and other metabolic pathways include oxidation by CYP3A4.
Interaction studies with medicinal products also metabolized with these pathways, like carbamazepine, diazepam, glibenclamide, nifedipine, and an oral contraceptive containing levonorgestrel and ethinyl oestradiol did not reveal clinically significant interactions.
An interaction of pantoprazole with other medicinal products or compounds, which are metabolized using the same enzyme system, cannot be excluded.
Results from a range of interaction studies demonstrate that pantoprazole does not affect the metabolism of active substances metabolised by CYP1A2 (such as caffeine, theophylline), CYP2C9 (such as piroxicam, diclofenac, naproxen), CYP2D6 (such as metoprolol), CYP2E1 (such as ethanol) or does not interfere with p-glycoprotein related absorption of digoxin.
There were no interactions with concomitantly administered antacids.
Interaction studies have also been performed by concomitantly administering pantoprazole concomitantly with the respective antibiotics (clarithromycin, metronidazole, amoxicillin) No clinically relevant interactions were found.
Medicinal products that inhibit or induce CYP2C19:
Inhibitors of CYP2C19 such as fluvoxamine could increase the systemic exposure of pantoprazole. A dose reduction may be considered for patients treated long-term with high doses of pantoprazole, or those with hepatic impairment.
Enzyme inducers affecting CYP2C19 and CYP3A4 such as rifampicin and St John´s wort (Hypericum perforatum) may reduce the plasma concentrations of PPIs that are metabolized through these enzyme systems.
Pantoprazole price in Kenya
Pantoprazole in Kenya
Clinical | Pharmacokinetic data
Routes of Administration: By mouth and intravenous
Protein Binding: Not Available
Metabolosim: Liver (CYP2C19)
Onset of Action:
Elimination Half life: 1-2 hours
Excretion: Urine, Feces
Legal Status | Dosage forms & Strengths
Prescription only Medicine (POM) , ℞-only
Narcotic Drugs and Psychotropic Substances (Control ) Act Schedule:
This Drug is not Subject to DDA drugs Act
Dosage Forms | Strengths:
Tablets | Capsules | injectables
|CompTox Dashboard (EPA)|
- PPB Retention Register
- Fitton, Andrew, and Lynda Wiseman. “Pantoprazole.” Drugs 51.3 (1996): 460-482.
- Huber, R., et al. “Pharmacokinetics of pantoprazole in man.” International journal of clinical pharmacology and therapeutics 34.5 (1996): 185-194.
- Jungnickel, Paul W. “Pantoprazole: a new proton pump inhibitor.” Clinical therapeutics 22.11 (2000): 1268-1293.