Pantoprazole adverse effects

PHENYTOIN PROTON PUMP INHIBITORS Possible t efficacy and adverse effects of phenytoin Unclear possible altered metabolism via CYP2C19 1 dose may be required. Use the proton pump inhibitor regularly, not PRN monitor phenytoin levels when starting or stopping treatment. Patients have received omeprazole for 3 weeks without altered phenytoin levels. Effect not reported with pantoprazole or rabeprazole... 

BZDs PROTON PUMP INHIBITORS -OMEPRAZOLE/ ESOMEPRAZOLE T efficacy and adverse effects, e.g. prolonged sedation Inhibition of metabolism via CYP4S0 (some show competitive inhibition via CYP2C19) Monitor for t side-effects, and 1 dose as necessaiy. Likely to delay recovery after procedures for which BZDs have been used. Consider alternative proton pump inhibitor, e.g. lansoprazole or pantoprazole... 

Pantoprazole 40 mg/day and ranitidine 150 mg bd for 8 weeks have been compared in the treatment of grades II and III reflux esophagitis in a randomized, double-bhnd trial in 256 patients (1). Symptom rehef and healing rates were significantly better with pantoprazole. The incidences of adverse effects were similar in the two groups the most commonly reported were diarrhea and somnolence with pantoprazole (2-3%) and headache, diarrhea, dizziness, increases in liver enzymes, and pruritus (2 %) with ranitidine. 

Pantoprazole 20 mg/day and ranitidine 300 mg/day for 12 months have been compared in the relief of symptoms in a multicenter, randomized, double-blind trial in 307 patients with symptomatic gastro-esophageal reflux disease in primary care (3). Symptom control was significantly more effective and faster with pantoprazole than ranitidine. Adverse effects were similar in the two groups the most common adverse effects were headache, diarrhea, nausea, constipation, and vomiting. 

Pantoprazole 40 mg/day and pantoprazole 40 mg/day plus cisapride 20 mg bd for 8 weeks have been compared in the treatment of gastro-esophageal reflux disease in a multicenter, randomized, double-blind trial in 350 patients (4). The addition of cisapride did not significantly improve symptom control or healing rates. The frequency of adverse effects in the two groups was similar. Compliance was worse in the pantoprazole plus cisapride group. 

Omeprazole multiple unit pellet system (MUPS) 20 mg/day and pantoprazole 40 mg/day for 8 weeks were more effective than lansoprazole 30 mg/day in relieving heartburn in a randomized, double-bhnd trial in 461 patients with sjmptomatic reflux esophagitis (15). Patient satisfaction and adverse effects were similar in the three groups. The most common adverse effects were diarrhea, headache, and nausea. 

The adverse effects profile of the proton pump inhibitors during short-term administration (under 12 weeks) is similar to that reported with short-term use of histamine receptor antagonists. The type and frequency of adverse effects reported with lansoprazole, omeprazole, pantoprazole, and rabeprazole are comparable. The most common adverse effects include headache, diarrhea, nausea, abdominal pain, constipation, dizziness, and skin rashes. 

L A 36-year-old woman with severe erosive esophagitis is prescribed pantoprazole. One of the most common adverse side effects of such therapy is which of the following ... 

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