Proton pump inhibitors drug interactions

Bhurke SM, Martin BC, Li C, Franks AM, Bursae Z, Said Q. Effect of the clopidogrel-proton pump inhibitor drug interaction on adverse cardiovascular events in patients with acute coronary syndrome. Pharmacotherapy 2012 32 809-18. 

Proton pump inhibitors can interact with other drugs by increasing gastric pH, inhibiting hepatic cytochrome... 

Drug interaction with proton pump inhibitors, unconjugated hyperbilirubinemia Twice daily dosing lipids Twice-daily dosing lipids... 

Drugs that may interact with laxatives include mineral oil, milk or antacids, H2 antagonists, proton pump inhibitors, lipid soluble vitamins (A, D, E, and K), and tetracycline. 

Itraconazole has significant interactions with a number of commonly prescribed drugs, such as rifampin, phenytoin, and carbamazepine. Itraconazole raises serum digoxin and cyclosporine levels and may affect the metabolism of oral hypoglycemic agents and coumadin. Absorption of itraconazole is impaired by antacids, Hj blockers, proton pump inhibitors, and drugs that contain buffers, such as the antiretroviral agent didanosine. 

CLARITHROMYCIN PROTON PUMP INHIBITORS -OMEPRAZOLE t efficacy and adverse effects of both drugs t plasma concentration of both drugs No dose adjustment recommended. Interaction considered useful for Helicobacter pylori eradication... 

Generally, only a few of the adverse drug interactions involving proton pump inhibitors are of clinical significance, but an awareness of all interactions is necessary as individual variations do occur. Metabolism involves CYP2C19 and CYP3A4, Individual proton pump inhibitors differ considerably in their potential for adverse drug interactions, which are due to ... 

Omeprazole is a proton pump inhibitor. Headache, skin rash, and diarrhea have all been recorded by adverse event registries sufficiently often to suggest causal relations (1). Omeprazole is a modest inhibitor of CYP isoforms. Interactions are less likely than with cimetidine and are probably of no practical importance. However, omeprazole reduces the absorption of drugs that require a low gastric pH (ketoconazole, iron salts, ampicilhn) and can inhibit the hepatic clearance of some drugs (diazepam, warfarin, phenytoin) (2). 

Itagaki F, Homma M,Yuzawa K, Fukao K, Kohda Y. Drug interaction of tacrolimus and proton pump inhibitors in renal transplant recipients with CYP2C19gene mutation.Transplant Proc 2002 34(7) 2777-8. 

Drug-Drug and Drug-Food Interactions. Drugs commonly used in the CKD population that may decrease absorption of oral iron include calcium preparations and antacids. Oral iron may also decrease the absorption of quinolone antibiotics. Medications that increase gastric pH such as H2-antagonists and proton pump inhibitors may also decrease iron absorption since iron absorption in the duodenum is maximized at an acidic pH. 

Single-dose interaction studies have demonstrated that concurrent administration of tolterodine LA with antacid leads to a rapid release of drug (70% within 4 hours) and results in a 1.5-fold elevation in tolterodine peak plasma concentration compared with placebo. The clinical implications of this interaction and whether a similar interaction exists with gastric acid suppressants such as the histamine H2 -receptor antagonists and proton pump inhibitors are unclear. In the same study, the pharmacokinetics of oxybutynin XL were unaltered by antacid administration. ... 

Juurlink DN, Gomes T, Ko DT, et al. A population-based study of the drug interaction between proton pump inhibitors and clopidogrel. CMAJ 2009 180(7) 713—718. 

The proton pump inhibitors do not appear to interact with alcohol, and no special precautions are necessary with concurrent use. But note that some of the conditions for which these drugs are used may be made worse by alcohol, so restriction of drinking of alcohol may be prudent. 

The authors suggest that the reduction in gastric acidity maintains TDB in its colloidal form, which is more likely to be absorbed, and that this may result in increased bismuth toxicity. Other H2-receptor antagonists, and other drugs that reduce gastric acidity would be expected to interact similarly (see also Bismuth compounds + Proton pump inhibitors , p.961). 

The polymeric enteric coating system also has resulted in differences in drug-drug interactions compared to the immediate release product, most notably with proton pump inhibitors. Omeprazole impairs the absorption and subsequent 12-hour exposure of MMF due to its incomplete dissolution in a more basic enviromnent, while EC-MPS pharmacokinetics were unaffected [59], Likewise, the manufacturer reports EC-MPS combined with pantoprazole did not yield altered kinetics [56],... 

Norgard NB, Mathews KD, Wall GC. Drug-drug interaction between clopidogrel and the proton pump inhibitors. Ann Pharmacother 2009 43(7) 1266-74. 

Howard PA, Vacek JL. Potential interaction between clopidogrel and proton pump inhibitors. Am J Cardiovasc Drugs 2009 9(6) 353-9. 

---