Pantoprazole Tacrolimus

CHjNaO 124-41-4) see Atorvastatin calcium Brinzolamide Ciprofloxacin Cisapride Dextrothyroxine Epirizole Hydroxyprogesterone Metaclazepam Moxifloxacin hydrochloride Moxonidine Oxcarbazepine Pantoprazole sodium Sulfadimethoxine Sulfalene Sulfamcthoxypyridazine Tacrolimus Vincamine sodium 3,4-(methylenedioxy)phenolate (CjHjNaOj 57f74-0i-5) sec Paroxetine sodium 4-nitrophenolate... 

Lorf T, Ramadori G, Ringe B, Schwdrer H. The effect of pantoprazole on tacrolimus and cyclosporin A blood concentration in transplant patients. EurJ Clin Pharmacol (2000) 56, 439-40. 

Schwrer H, Lorf T, Ringe B, Ramadori G. Pantoprazole and cyclosporine or tacrolimus. Aliment Pharmacol Ther( 00 ) 15,561-2. 

Lansoprazole may increase tacrolimus levels in patients with low levels of the cytochrome P4S0 isoenzyme CYP2C19. Pantoprazole and omeprazole are predicted to interact similarly. Rabeprazole appears not to interact with tacrolimus. 

A study in 6 transplant patients taking tacrolimus found that pantoprazole 40 mg once daily for 5 days did not significantly affect the trough levels of tacrolimus. ... 

The incidence of the interaction between tacrolimus and lansoprazole is unknown. It would seem to most frequently occur in those with decreased CYP2C19 activity, and therefore it is not easy to predict which patients would be affected. The manufacturers of tacrolimus say that this interaction may also occur with omeprazole, which is metabolised in the same way as lansoprazole. It would seem prudent to monitor tacrolimus levels if either of these proton pump inhibitors is started or stopped. Although no interaction was noted in the study with pantoprazole the authors do note that it may interact like lansoprazole in patients with CYP2C19 deficiency. Rabeprazole may be a suitable alternative proton pump inhibitor as limited evidence suggests that it does not interact, and nor would it be expected to do so. 

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