- Pantoprazole
- Esomeprazole
- Omeprazole
- Rabeprazole
Correct Answer : Rabeprazole
Ref: K.D Tripathi 6th edition page no 632-633
Cytochrome P450 enzymes are inhibited by Omeprazole, Esomeprazole and Pantoprazole
Rabiprazole has the least or no inhibitory action on Cytochrome P450 enzymes (http://www.ncbi.nlm.nih.gov/pubmed/15258107)
Omeprazole and Esomeprazole is a competitive inhibitor of the enzymes CYP2C19 and CYP2C9, and therefore interact with diazepam, escitalopram, and warfarin; increasing the concentration of these drugs.
Clopidogrel is an inactive prodrug that partially depends on CYP2C19 for conversion to its active form; inhibition of CYP2C19 blocks the activation of clopidogrel, thus reducing its effects and potentially increasing the risk of stroke and ischemic heart disease
Pantoprazole also inhibits CYP450 enzymes , but has much lower affinity compared to Omeprazole
Rabeprazole does not inhibit CYP450 and so is compatible with any medicine metabolized by the CYP450 enzymes (theophylline, warfarin, diazepam ,phenytoin).
Cytochrome P450 inhibitors
– Ciprofloxacin, Pefloxacin and Norfloxacin ( but not Levofloxacin)
– Erythromycin (not Azithromycin)
– Isoniazid
– Proton pump inhibitors (except Rabiprazole)
– Cimetidine
– Diltiazem, verapamil
– Amiodarone
– Fluoxetine
– Ticlopidine
– ketoconazole
– HIV protease inhibitors ( except Saquinavir)
Cytochrome P450 inducers
– Rifampicin
– Carbemazapine
– Phenobarbitone
– Phenytoin
– Ritonavir
– Tobacco
– Ethanol
Cytochrome P450 enzymes are inhibited by Omeprazole, Esomeprazole and Pantoprazole
Rabiprazole has the least or no inhibitory action on Cytochrome P450 enzymes (http://www.ncbi.nlm.nih.gov/pubmed/15258107)
Omeprazole and Esomeprazole is a competitive inhibitor of the enzymes CYP2C19 and CYP2C9, and therefore interact with diazepam, escitalopram, and warfarin; increasing the concentration of these drugs.
Clopidogrel is an inactive prodrug that partially depends on CYP2C19 for conversion to its active form; inhibition of CYP2C19 blocks the activation of clopidogrel, thus reducing its effects and potentially increasing the risk of stroke and ischemic heart disease
Pantoprazole also inhibits CYP450 enzymes , but has much lower affinity compared to Omeprazole
Rabeprazole does not inhibit CYP450 and so is compatible with any medicine metabolized by the CYP450 enzymes (theophylline, warfarin, diazepam ,phenytoin).
Cytochrome P450 inhibitors
– Ciprofloxacin, Pefloxacin and Norfloxacin ( but not Levofloxacin)
– Erythromycin (not Azithromycin)
– Isoniazid
– Proton pump inhibitors (except Rabiprazole)
– Cimetidine
– Diltiazem, verapamil
– Amiodarone
– Fluoxetine
– Ticlopidine
– ketoconazole
– HIV protease inhibitors ( except Saquinavir)
Cytochrome P450 inducers
– Rifampicin
– Carbemazapine
– Phenobarbitone
– Phenytoin
– Ritonavir
– Tobacco
– Ethanol