• 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  diazepamescitalopram, 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 (theophyllinewarfarindiazepam ,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
Cyt P450 enzymes are inhibited by all except

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