Pantoprazole Theophylline

Co-administration of either lansoprazole or pantoprazole in healthy subjects did not affect the steady-state pharmacokinetics of theophylline in therapeutic doses (74). 

Pan WJ, Goldwater DR, Zhang Y, Pilmer BL, Hunt RH. Lack of a pharmacokinetic interaction between lansoprazole or pantoprazole and theophylline. Aliment Pharmacol Ther 2000 14(3) 345-52. 

A crossover study in 8 healthy subjects showed that intravenous pantoprazole 30 mg daily had no clinically important effect on the pharmacokinetics of theophylline given by infiision. No clinically relevant changes in blood pressure, heart rate, ECG and routine clinical laboratory parameters were seen. Other studies have also found no significant change in theophylline pharmacokinetics when pantoprazole was given. ... 

Schulz H-U, Hartmann M, Steinijans VW, Huber R, Luhrmann B, Bliessath H, Wurst W. Lack of influence of pantoprazole on the disposition kinetics of theophylline in man. IntJ Clin Pharmacol Ther Toxicol (1991) 29, 369-75. 

CYP lAl and 1A2 are engaged in bioconversion of a limited number of drugs, including caffeine and theophylline [20]. Both omeprazole and lansoprazole are able to induce these isoforms in vitro [62,63]. Such induction seems to be transient, as reported for omeprazole in vitro [63]. As to pantoprazole, a less pronounced induction has been reported in rat liver microsomes [64], while only elevated CYPl A1 messenger RNA (mRNA) levels were observed in a human hepatoma cell line [65]. 

Negative results with pantoprazole in this area are less than conclusive, since the interaction potential with theophylline has only been studied at a pantoprazole dose of 30 mg applied by 2-min injections [58], so that the period of liver exposure was lower than in the clinical setting. Even so, a nonsignificant decrease in elimination half-life by 10% was noted. Lansoprazole hastening of theophylline elimination appears inconsiderable from a practical point of view. More important are concerns over possible links between cancerogenesis and inducibility of lA isoforms. The ambiguities of this issue have been mooted previously. In the present context, it may suffice to emphasize that the 1A induction by PPIs is trivial in magnitude, probably transient and may even have positive aspects [41]. 

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