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Pantoprazole may increase gastrointestinal pH, concurrent use with ampicillin esters, iron salts or ketoconazole may result in a reduction in absorption of these medications.
Inhibition of the cytochrome P-450 enzyme system by pantoprazole, especially in high doses, may cause a decrease in the hepatic metabolism of anticoagulants (coumarin or indadione-derivative), diazepam or phenytoin, which may result in delayed elimination and increased blood concentrations, when these medications are used concurrently with pantoprazole.
Concurrent use of pantoprazole with bone marrow depressants may increase the leukopenic and/or thrombocytopenic effects of both medications. If concurrent use is required, dose observation for toxic effects should be considered.
