pantoprazole

パントプラゾール

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/07/12 09:29:58」(JST)

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Pantoprazole

Systematic (IUPAC) name
(RS)-6-(Difluoromethoxy)-2-[(3,4-dimethoxypyridin-2-yl)methylsulfinyl]-1H-benzo[d]imidazole
Clinical data
Trade names	Protonix
AHFS/Drugs.com	monograph
MedlinePlus	a601246
Licence data	US FDA:link
Pregnancy category	AU: B3 US: B (No risk in non-human studies)
Legal status	℞ (Prescription only)
Routes of administration	Oral and intravenous
Pharmacokinetic data
Bioavailability	77%
Metabolism	Hepatic (CYP3A4)
Biological half-life	1 hour
Excretion	Renal
Identifiers
CAS Registry Number	102625-70-7 Y
ATC code	A02BC02
PubChem	CID: 4679
IUPHAR/BPS	7260
DrugBank	DB00213 Y
ChemSpider	4517 Y
UNII	D8TST4O562 Y
KEGG	D05353 Y
ChEBI	CHEBI:7915 Y
ChEMBL	CHEMBL1502 Y
Chemical data
Formula	C16H15F2N3O4S
Molecular mass	383.371 g/mol
SMILES FC(F)Oc3cc1c(nc(n1)S(=O)Cc2nccc(OC)c2OC)cc3
InChI InChI=1S/C16H15F2N3O4S/c1-23-13-5-6-19-12(14(13)24-2)8-26(22)16-20-10-4-3-9(25-15(17)18)7-11(10)21-16/h3-7,15H,8H2,1-2H3,(H,20,21) Y Key:IQPSEEYGBUAQFF-UHFFFAOYSA-N Y
Y (what is this?)  (verify)

Pantoprazole is a proton pump inhibitor drug that inhibits gastric acid secretion. It was first marketed under the brand name Protonix.

Medical uses

Pantoprazole is used for short-term treatment of erosion and ulceration of the esophagus caused by gastroesophageal reflux disease. Initial treatment is generally of eight weeks' duration, after which another eight-week course of treatment may be considered if necessary. It can be used as a maintenance therapy for long-term use after initial response is obtained. Pantoprazole may also be used in combination with antibiotics to treat ulcers caused by Helicobacter pylori. When treating H. pylori ulcers, pantoprazole is given twice daily, in contrast to gastroesophageal reflux disease, where it is usually given once daily. Typical treatment courses for H. pylori range from 10 to 14 days.

Adverse effects

• Infection: Stomach acid plays a role in killing ingested bacteria. Use of pantoprazole may increase the chance of developing infections such as pneumonia, particularly in hospitalized patients.

Common

• Gastrointestinal: abdominal pain (3%), diarrhea (4%), flatulence (4%)
• Neurologic: headache (5%)

Serious

• Gastrointestinal: atrophic gastritis, Clostridium difficile diarrhea
• Hematologic: thrombocytopenia (less than 1%)
• Immunologic: Stevens-Johnson syndrome, toxic epidermal necrolysis
• Musculoskeletal: Muscle disorders, bone fracture and infection, Clostridium difficile infection, osteoporosis-related hip fracture, rhabdomyolysis
• Renal: interstitial nephritis (rare)
• Nutrition: may reduce the absorption of important nutrients, vitamins and minerals, as well as medications, leaving users at increased risk for pneumonia
• Cardiovascular: increase in a chemical that suppresses the production of nitric oxide by 25% in humans, which has proven to relax and protect arteries and veins, causes blood vessels to constrict, a development that could lead to a number of cardiovascular problems if continued for a prolonged time

Pharmacology

Wyeth pantoprazole 20-mg

Pantoprazole is metabolized in the liver by the cytochrome P450 system. Metabolism mainly consists of demethylation by CYP2C19 followed by sulfation. Another metabolic pathway is oxidation by CYP3A4. Pantoprazole metabolites are not thought to have any pharmacological significance. Pantoprazole is relatively free of drug interactions; however, it may alter the absorption of other medications that depend on the amount of acid in the stomach, such as ketoconazole or digoxin. Generally inactive at the acidic pH of stomach, thus it is usually given with a prokinetic drug. Pantoprazole binds irreversibly to H+K+ATPase (proton pumps) and suppresses the secretion of acid. As it binds irreversibly to the pumps, new pumps have to be made before acid production can be resumed. The drug's plasma half-life is about 2 hours.

Availability

Pantoprazole was developed by Altana (owned by Nycomed) and was licensed in the USA to Wyeth (which was taken over by Pfizer). It was initially marketed under the brand name Protonix by Wyeth-Ayerst Laboratories, and now is available as a generic. It is available by prescription in delayed-release tablets. It is also available for intravenous use.

As of March 2015 Pantoprazole was available as a generic drug from a range of international suppliers under many brand names.

See also

• Lansoprazole

References

External links

• Protonix (Pantoprazole Sodium) label

UpToDate Contents

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English Journal

• Comparison of the efficacy and safety of pantoprazole magnesium and pantoprazole sodium in the treatment of gastro-oesophageal reflux disease: a randomized, double-blind, controlled, multicentre trial.

• Hein J.SourceArzt fur Innere Medizin, Marburg, Germany.
• Clinical drug investigation.Clin Drug Investig.2011 Sep 1;31(9):655-64. doi: 10.2165/11590270-000000000-00000.
• Background: Proton pump inhibitors (PPIs) are well established as first-line agents for the treatment of moderate-to-severe gastro-oesophageal reflux disease (GORD). Although all PPIs heal oesophageal lesions and provide symptomatic relief, breakthrough symptoms may occur as acidity levels rebound.
• PMID 21819161

• Relationship between cardiovascular outcomes and proton pump inhibitor use in patients receiving dual antiplatelet therapy after acute coronary syndrome.

• Hsiao FY, Mullins CD, Wen YW, Huang WF, Chen PF, Tsai YW.SourceGraduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan. fyshsiao@ntu.edu.tw.
• Pharmacoepidemiology and drug safety.Pharmacoepidemiol Drug Saf.2011 Aug 8. doi: 10.1002/pds.2202. [Epub ahead of print]
• BACKGROUND: There is conflicting evidence regarding the potential interaction between clopidogrel and proton pump inhibitors (PPIs), with observational studies suggesting an increased risk of adverse cardiovascular (CV) outcomes and clinical trials suggesting there is no such risk.METHODS: We conduc
• PMID 21823195

Japanese Journal

• ファモチジンはpantoprazoleよりアスピリン関連消化性潰瘍、びらんの再発予防効果が劣る

• 坂本 長逸 [訳],Ng Fook-Hong,Wong Siu-Yin [他]
• Review of gastroenterology & clinical gastroenterology and hepatology 5(2), 12-15, 2010-08
• NAID 40017253395

• Effect of an Herbal Preparation, STW 5, in an Acute Model of Reflux Oesophagitis in Rats

• Abdel-Aziz Heba,Zaki Hala F.,Neuhuber Winfried,Kelber Olaf,Weiser Dieter,Khayyal Mohamed T.
• Journal of Pharmacological Sciences advpub(0), 1005180387, 2010
• … Pantoprazole was used as a reference standard. …
• NAID 130000251912

Related Links

• パントプラゾール PANTOPRAZOLE ベンズイミダゾール系 プロトンポンプ ...

有効成分（日）, パントプラゾール. 有効成分（英）, Pantoprazole. 同成分薬, パントゾール プロトニックス. 含有量, 40ミリグラム. 形態, タブレット. ▼ご希望の 商品と数量をお選びください. ゾバンタ. ZOVANTA. 含有量 40ミリグラム ...

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