Pantokem-D Drug Interactions

Pantoprazole: Pantoprazole is metabolized through the cytochrome P450 system, primarily the CYP2C19 and CYP3A4 isoenzymes, and subsequently undergoes phase II conjugation. Based on studies evaluating possible interactions of Pantoprazole with other drugs metabolized by the cytochrome P450 system, no dosage adjustment is needed with concomitant use of the following drugs: theophylline, cisapride, antipyrine, caffeine, carbamazepine diazepam, diclofenac, digoxin, ethanol, glyburide, oral contraceptives (levonorgestrel/ethynyl estradiol), metoprolol, nifedipine, phenytoin or warfarin. Clinically relevant interactions of Pantoprazole with other drugs with the same metabolic pathways are not expected. Therefore, when co-administered with Pantoprazole, adjustment of the dosage of Pantoprazole with such drugs may not be necessary. There was also no interaction with concomitantly administered antacids.
Because of profound and long lasting inhibition of gastric acid secretion, it is theoretically possible that Pantoprazole may interfere with absorption of drugs where gastric pH is an important determinant of their bioavailability (e.g. Ketoconazole, Ampicillin esters, and iron salts).
Domperidone: Anti-cholinergic drugs may inhibit the anti-dyspeptic effects of Domperidone. Antimuscarinic agents and opioid analgesics may antagonise the effect of Domperidone. Domperidone suppresses the peripheral effects (digestive disorders, nausea and vomiting) of dopaminergic agonists. Since Domperidone has gastro-kinetic effects, it could influence the absorption of concomitant orally administered drugs, particularly those with sustained release or enteric coated formulations.
As Domperidone interferes with serum prolactin levels, it may interfere with other hypoprolactinaemic agents and with some diagnostic tests.
Antacids and anti-secretory agents lower the oral bioavailability of Domperidone. They should be taken after meals and not before meals, i.e. they should not be taken simultaneously with Domperidone. Reduced gastric acidity impairs the absorption of Domperidone.
Oral bioavailability is decreased by prior administration of Cimetidine or Sodium Carbonate.