Drug Safety

, Volume 16, Issue 3, pp 171–179 | Cite as

Drug Interactions with Proton Pump Inhibitors

  • Peter Unge
  • Tommy Andersson
Review Article Drug Experience


Omeprazole, lansoprazole and pantoprazole are all mainly metabolised by the polymorphically expressed cytochrome P450 (CYP) isoform CYP2C19 (S-mephenytoin hydroxylase). All 3 proton pump inhibitors have a very limited potential for drug interactions at the CYP level. Small effects on CYP reported for these compounds are usually of no clinical relevance. No dose related adverse effects have been identified, suggesting that the small proportion of slow metabolisers is at no additional risk for clinically important drug interactions.

The absorption of some compounds, e.g. benzylpenicillin (penicillin G), are altered during treatment with proton pump inhibitors as a result of the increased intragastric pH. A synergy has been confirmed between omeprazole and amoxicillin or clarithromycin in the antibacterial effect against Helicobacter pylori.


Theophylline Omeprazole Proton Pump Inhibitor Lansoprazole Tolbutamide 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Fellenius E, Berglindh T, Sachs G, et al. Substituted benzimidazoles inhibit gastric acid secretion by blocking (H++ K+)ATPase. Nature 1981; 290: 159–61PubMedGoogle Scholar
  2. 2.
    Lindberg P, Nordberg P, Alminger T, et al. The mechanism of action of the gastric acid secretion inhibitor omeprazole. J Med Chem 1986; 29: 1327–9PubMedGoogle Scholar
  3. 3.
    Shin JM, Besancon M, Prinz C, et al. Continuing development of acid pump inhibitors: site of action of pantoprazole. Aliment Pharmacol Ther 1994; 8 Suppl. 1: 11–23PubMedGoogle Scholar
  4. 4.
    Lind T, Cederberg C, Ekenved G, et al. Effect of omeprazole — a gastric proton pump inhibitor — on pentagastrin stimulated acid secretion in man. Gut 1983; 24: 270–6PubMedGoogle Scholar
  5. 5.
    Brändström A, Lindberg P, Bergman NÅ, et al. Chemical reactions of omeprazole and omeprazole analogues. Acta Chem Scand 1989; 43: 536–611Google Scholar
  6. 6.
    Andersson T. Pharmacokinetics, metabolism and interactions of acid pump inhibitors. Clin Pharmacokinet 1996; 31(1): 9–28PubMedGoogle Scholar
  7. 7.
    Pilbrant Å, Cederberg C. Development of an oral formulation of omeprazole. Scand J Gastroenterol 1985; 20 Suppl. 108: 113–20Google Scholar
  8. 8.
    Andersson T, Andrén K, Cederberg C, et al. Bioavailability of omeprazole as enteric coated (EC) granules in conjunction with food on the first and seventh days of treatment. Drug Invest 1990; 2: 184–8Google Scholar
  9. 9.
    Benet LZ, Zech K. Pharmacokinetics — a relevant factor for the choice of a drug?. Aliment Pharmacol Ther 1994; 8 Suppl. 1: 25–32PubMedGoogle Scholar
  10. 10.
    Delhotal-Landes B, Cournot A, Vermerie N, et al. The effect of food and antacids on lansoprazole absorption and disposition. Eur J Drug Metab Dispos 1991; Special Issue No III: 315-20Google Scholar
  11. 11.
    Bergstrand R, Grind M, Nyberg G, et al. Decreased oral bioavailability of lansoprazole in healthy volunteers when given with a standardised breakfast. Clin Drug Invest 1995; 9: 67–71Google Scholar
  12. 12.
    Tuynman HARE, Festen HPM, Röhss K. Lack of effect of antacids on plasma concentrations of omeprazole given as enteric-coated granules. Br J Clin Pharmacol 1987; 24; 833–5PubMedGoogle Scholar
  13. 13.
    Hartmann M, Bliesath H, Huber R, et al. Lack of influence of antacids on the pharmacokinetics of the new gastric H+/ K+-ATPase inhibitor pantoprazole [abstract]. Gastroenterology 1994; 106 Suppl.: A91Google Scholar
  14. 14.
    Lanzon-Miller S, Pounder RE, Hamilton MR, et al. Twenty-four-hour intragastric acidity and plasma gastrin concentration before and during treatment with either ranitidine or omeprazole. Aliment Pharmacol Ther 1987; 1: 239–51PubMedGoogle Scholar
  15. 15.
    Mayersohn M. Physiological factors that modify systemic drug availability and pharmacologic response in clinical practice. In: Blanchard et al., editors. Principles and perspectives in drug bioavailability. Basel: Karger, 1979: 211–73Google Scholar
  16. 16.
    Oosterhuis B, Jonkman JHG, Andersson T, et al. Minor effect of multiple dose omeprazole on the pharmacokinetics of digoxin after a single oral dose. Br J Clin Pharmacol 1991; 32: 569–72PubMedGoogle Scholar
  17. 17.
    Soons PA, van den Berg G, Danhof M, et al. Influence of single-and multiple-dose omeprazole treatment on nifedipine pharmacokinetics and effects in healthy subjects. Eur J Clin Pharmacol 1992; 42: 319–24PubMedGoogle Scholar
  18. 18.
    Cohen AF, Kroon R, Schoemaker R, et al. Influence of gastric acidity on the bioavailability of digoxin. Ann Intern Med 1991; 115: 540–5PubMedGoogle Scholar
  19. 19.
    Paulsen O, Höglund P, Walder M. No effect of omeprazole induced hypoacidity on the bioavailability of amoxycillin or bacampicillin. Scand J Infect Dis 1989; 21: 219–23PubMedGoogle Scholar
  20. 20.
    Bergstrand R, Idström JP, Eriksson S. Bioavailability of penicillin during omeprazole treatment. Sweden: Astra Hässle AB, 1996 (Data on file)Google Scholar
  21. 21.
    Hartmann M, Huber R, Bliesath H, et al. Lack of interaction between pantoprazole and digoxin at therapeutic doses in man [Abstracts]. In: Management of acid-related diseases: focus on pantoprazole. Berlin: Charité, 1993: 34–5Google Scholar
  22. 22.
    Bliesath H, Huber R, Hartmann M, et al. Pantoprazole does not influence the steady-state pharmacokinetics of nifedipine [abstract]. Gastroenterol 1994; 106 Suppl.: A55Google Scholar
  23. 23.
    Piscitelli SC, Goss TF, Wilton JH, et al. Effects of ranitidine and sucralfate on ketoconazole bioavailability. Antimicrob Agents Chemother 1991; 35: 1765–71PubMedGoogle Scholar
  24. 24.
    Nebert DW, McKinnon RA. Cytochrome P450: evolution and functional diversity. In: Prog Liver Dis 1994; 12: 63–97Google Scholar
  25. 25.
    de Morais SMF, Wilkinson GR, Blaisdell J, et al. The major genetic defect responsible for the polymorphism of 5-mephenytoin metabolism in humans. J Biol Chem 1994; 269: 15419–22PubMedGoogle Scholar
  26. 26.
    Nielsen MD, Brösen K, Gram LF. A dose — effect study of the in vivo inhibitory effect of quinidine on sparteine oxidation in man. Br J Clin Pharmacol 1990; 29: 299–304PubMedGoogle Scholar
  27. 27.
    Goldstein JA, Faletto MB, Romkes-Sparks M, et al. Evidence that CYP2C19 is the major (S)-mephenytoin 4′-hydroxylase in humans. Biochemistry 1994; 33: 1743–52PubMedGoogle Scholar
  28. 28.
    Andersson T, Regårdh CG, Dahl-Puustinen ML, et al. Slow omeprazole metabolizers are also poor 5-mephenytoin hydroxylators. Ther Drug Monit 1990; 12: 415–6PubMedGoogle Scholar
  29. 29.
    Andersson T, Regârdh CG, Lou YC, et al. Polymorphic hydroxylation of 5-mephenytoin and omeprazole metabolism in Caucasian and Chinese subjects. Pharmacogenetics 1992; 2: 25–31PubMedGoogle Scholar
  30. 30.
    Sohn DR, Kobayashi K, Chiba K, et al. Disposition kinetics and metabolism of omeprazole in extensive and poor metabolizers of 5-mephenytoin 4-hydroxylation recruited from an oriental population. J Pharmacol Exp Ther 1992; 262: 1195–202PubMedGoogle Scholar
  31. 31.
    Ishizaki T, Sohn DR, Kobayashi K, et al. Interethnic differences in omeprazole metabolism in the two 5-mephenytoin hydrox-ylation phenotypes studied in Caucasians and Orientals. Ther Drug Monit 1994; 16: 214–5PubMedGoogle Scholar
  32. 32.
    Andersson T, Miners JO, Veronese ME, et al. Identification of human liver cytochrome P450 isoforms mediating omeprazole metabolism. Br J Clin Pharmacol 1993; 36: 521–30PubMedGoogle Scholar
  33. 33.
    Chiba K, Kobayashi K, Manabe K, et al. Oxidative metabolism of omeprazole in human liver microsomes: cosegregation with S-mephenytoin 4′-hydroxylation. J Pharmacol Exp Ther 1993; 266: 52–9PubMedGoogle Scholar
  34. 34.
    Andersson T, Miners JO, Veronese ME, et al. Identification of human liver cytochrome P450 isoforms mediating secondary omeprazole metabolism. Br J Clin Pharmacol 1994; 37: 597–604PubMedGoogle Scholar
  35. 35.
    Tucker GT. The interaction of proton pump inhibitors with cytochromes P450. Aliment Pharmacol Ther 1994; 8 Suppl. 1: 33–8PubMedGoogle Scholar
  36. 36.
    Huber R, Kohl B, Sachs G, et al. Review article: the continuing development of proton pump inhibitors with particular reference to pantoprazole. Aliment Pharmacol Ther 1995; 9: 363–78PubMedGoogle Scholar
  37. 37.
    Schultz HU, Hartmann M, Steinijans VW, et al. Lack of influence of pantoprazole on the disposition kinetics of theophylline in man. Int J Clin Pharmacol Ther Toxicol 1991; 29: 369–75Google Scholar
  38. 38.
    Pantuck EJ, Hsiao KC, Maggio A, et al. Effect of cigarette smoking on phenacetin metabolism. Clin Pharmacol Ther 1974; 15: 9–17PubMedGoogle Scholar
  39. 39.
    Pantuck EJ, Pantuck CB, Garland WA, et al. Stimulatory effect of brussel sprouts and cabbage on human drug metabolism. Clin Pharmacol Ther 1979; 25: 88–95PubMedGoogle Scholar
  40. 40.
    Conney AH, Pantuck EJ, Hsiao KC, et al. Enhanced phenacetin metabolism in human subjects fed charcoal-broiled beef. Clin Pharmacol Ther 1976; 20: 633–42PubMedGoogle Scholar
  41. 41.
    Grant DM, Campbell ME, Tang BK, et al. Biotransformation of caffeine by microsomes from human liver. Biochem Pharmacol 1987; 36: 1251–60PubMedGoogle Scholar
  42. 42.
    Sesardic D, Boobis AR, Edwards RJ, et al. A form of cytochrome P450 in man, orthologous to form d in the rat, catalyses the O-deethylation of phenacetin and is inducible by cigarette smoking. Br J Clin Pharmacol 1988; 26: 363–72PubMedGoogle Scholar
  43. 43.
    Robson RA, Miners JO, Matthews AP, et al. Characterisation of theophylline metabolism by human liver microsomes. Biochem Pharmacol 1988; 37: 1651–9PubMedGoogle Scholar
  44. 44.
    Sarkar MA, Hunt C, Guzelian PS, et al. Characterisation of human liver cytochromes P450 involved in theophylline metabolism. Drug Metab Dispos 1992; 20: 31–7PubMedGoogle Scholar
  45. 45.
    Zhang ZY, Kaminsky LS. Characterisation of human cytochromes P450 involved in theophylline 8-hydroxylation. Biochem Pharmacol 1995; 50: 205–11PubMedGoogle Scholar
  46. 46.
    Andersson T, Bergstrand R, Cederberg C, et al. Omeprazole treatment does not affect the metabolism of caffeine. Gastro-enterology 1991; 101: 943–7Google Scholar
  47. 47.
    Rost KL, Brösicke H, Brockmöller J, et al. Increase of cytochrome P4501A2 activity by omeprazole: evidence by the 13C-(N-3-methyl)-caffeine breath test in poor and extensive metabolizers of 5-mephenytoin. Clin Pharmacol Ther 1992; 52: 170–80PubMedGoogle Scholar
  48. 48.
    Xiaodong S, Gatti G, Bartoli A, et al. Omeprazole does not enhance the metabolism of phenacetin, a marker of CYP1A2 activity, in healthy volunteers. Ther Drug Monit 1994; 16: 248–50PubMedGoogle Scholar
  49. 49.
    Gugler R, Jensen JC. Drugs other than H2-receptor antagonists as clinically important inhibitors of drug metabolism in vivo. Pharmacol Ther 1987; 33: 133–7PubMedGoogle Scholar
  50. 50.
    Oosterhuis B, Jonkman JHG, Andersson T, et al. No influence of single intravenous doses of omeprazole on theophylline elimination kinetics. J Clin Pharmacol 1992; 32: 470–5PubMedGoogle Scholar
  51. 51.
    Taburet AM, Geneve J, Bocquentin M, et al. Theophylline steady state pharmacokinetics is not altered by omeprazole. Eur J Clin Pharmacol 1992; 42: 343–5PubMedGoogle Scholar
  52. 52.
    Granneman G, Winters EP, Locke CS, et al. Lack of effect of concomitant lansoprazole on steady state theophylline pharmacokinetics [abstract]. Gastroenterology 1991; 100: A75Google Scholar
  53. 53.
    Doecke CJ, Veronese ME, Pond SM, et al. Relationship between phenytoin and tolbutamide hydroxylations in human liver microsomes. Br J Clin Pharmacol 1991; 31: 125–30PubMedGoogle Scholar
  54. 54.
    Yasumori T, Chen LS, Li QH, et al. Regio- and stereo-selective metabolism of phenytoin by cytochrome P450s in human livers [abstract]. Proceedings from 10th International Symposium on Microsomes & Drug Oxidations: 1994 Jul 18-21; Toronto, Canada; 588Google Scholar
  55. 55.
    Relling MV, Aoyama T, Gonzales FJ, et al. Tolbutamide and mephenytoin hydroxylation by human cytochrome P450s in the CYP2C subfamily. J Pharmacol Exp Ther 1990; 252: 442–7PubMedGoogle Scholar
  56. 56.
    Chen LS, Yasumori T, Yamazoe Y, et al. Hepatic microsomal tolbutamide hydroxylation in Japanese: in vitro evidence for rapid and slow metabolisers. Pharmacogenetics 1993; 3: 77–85PubMedGoogle Scholar
  57. 57.
    Tassaneeyakul W, Veronese ME, Birkett DJ, et al. Co-regulation of phenytoin and tolbutamide metabolism in humans. Br J Clin Pharmacol 1992; 34: 494–8PubMedGoogle Scholar
  58. 58.
    Kaminsky LS, de Morais SM, Faletto MB, et al. Correlation of human cytochrome P450C substrate specificities with primary structure: warfarin as a probe. Mol Pharmacol 1993; 43: 234–9PubMedGoogle Scholar
  59. 59.
    Gugler R, Jensen JC. Omeprazole inhibits oxidative drug metabolism- studies with diazepam and phenytoin in vivo and 7-ethoxycoumarin in vitro. Gastroenterology 1985; 89: 1235–41PubMedGoogle Scholar
  60. 60.
    Prichard PJ, Walt RP, Kitchingman GK, et al. Oral phenytoin pharmacokinetics during omeprazole therapy. Br J Clin Pharmacol 1987; 24: 543–5PubMedGoogle Scholar
  61. 61.
    Bachmann KA, Sullivan TJ, Jauregui L, et al. Absence of an inhibitory effect of omeprazole and nizatidine on phenytoin disposition, a marker of CYP2C activity. Br J Clin Pharmacol 1993; 36: 380–2PubMedGoogle Scholar
  62. 62.
    Andersson T, Lagerström PO, Unge P. A study of the interaction between omeprazole and phenytoin in epileptic patients. Ther Drug Monit 1990; 12: 329–33PubMedGoogle Scholar
  63. 63.
    Karol MD, Mukherji D, Cavanaugh JH. Lack of effect of concomitant multi-dose lansoprazole on single-dose phenytoin pharmacokinetics in subjects [abstract]. Gastroenterology 1994; 106 Suppl.:A103Google Scholar
  64. 64.
    Middle MV, Müller FO, Schall R, et al. No influence of pantoprazole on the pharmacokinetics of phenytoin. Int J Clin Pharmacol Ther 1995; 33: 304–7PubMedGoogle Scholar
  65. 65.
    Sutfin T, Balmér K, Boström H, et al. Stereoselective interaction of omeprazole with warfarin in healthy men. Ther Drug Monit 1989; 11: 176–84PubMedGoogle Scholar
  66. 66.
    Unge P, Svedberg LE, Nordgren A, et al. A study of the interaction of omeprazole and warfarin in anticoagulated patients. Br J Clin Pharmacol 1992; 34: 509–12PubMedGoogle Scholar
  67. 67.
    Cavanaugh JH, Winters EP, Cohen A, et al. Lack of effect of lansoprazole on steady state warfarin metabolism [abstract]. Gastroenterology 1991; 100 Suppl.: A40Google Scholar
  68. 68.
    Duursema L, Müller FO, Schall R, et al. Lack of effect of pantoprazole on the pharmacodynamics and pharmacokinetics of warfarin. Br J Clin Pharmacol 1995; 39: 700–3PubMedGoogle Scholar
  69. 69.
    Toon S, Holt BL, Mullins FGP, et al. Effects of cimetidine, ranitidine and omeprazole on tolbutamide metabolism. J Pharm Pharmacol 1995; 47: 85–8Google Scholar
  70. 70.
    Hall SD, Hamman MA, Rettie AE, et al. Relationships between the levels of cytochrome P4502C9 and its prototypic catalytic activities in human liver microsomes. Drug Metab Dispos 1994; 22: 975–8PubMedGoogle Scholar
  71. 71.
    Bertilsson L, Henthorn TK, Sanz E, et al. Importance of genetic factors in the regulation of diazepam metabolism: relationship to S-mephenytoin, but not debrisoquine, hydroxylation phe-notype. Clin Pharmacol Ther 1989; 45: 348–55PubMedGoogle Scholar
  72. 72.
    Andersson T, Miners JO, Veronese ME, et al. Diazepam metabolism by human liver microsomes is mediated by both S-mephenytoin hydroxylase and CYP3A isoforms. Br J Clin Pharmacol 1994; 38: 131–7PubMedGoogle Scholar
  73. 73.
    Funck-Brentano C, Bosco O, Jacqz-Aigrain E, et al. Relation between chloroguanide bioactivation to cycloguanil and the genetically determined metabolism of mephenytoin in humans. Clin Pharmacol Ther 1992; 51: 507–12PubMedGoogle Scholar
  74. 74.
    Birkett DJ, Rees D, Andersson T, et al. In vitro proguanil activation to cycloguanil by human liver microsomes is mediated by CYP3A isoforms as well as by S-mephenytoin hydroxylase. Br J Clin Pharmacol 1994; 37: 413–20PubMedGoogle Scholar
  75. 75.
    Andersson T, Cederberg C, Edvardsson G, et al. Effect of omeprazole treatment on diazepam plasma levels in slow versus normal rapid metabolizers of omeprazole. Clin Pharmacol Ther 1990; 47: 79–85PubMedGoogle Scholar
  76. 76.
    Andersson T, Andrén K, Cederberg C, et al. Effect of omeprazole and cimetidine on plasma diazepam levels. Eur J Clin Pharmacol 1990; 39: 51–4PubMedGoogle Scholar
  77. 77.
    Lefebvre RA, Flouvat B, Karolac-Tamisier S, et al. Influence of lansoprazole treatment on diazepam plasma concentrations. Clin Pharmacol Ther 1992; 52: 458–63PubMedGoogle Scholar
  78. 78.
    Gugler R, Hartmann M, Rudi J, et al. Lack of interaction of pantoprazole and diazepam in man [abstract]. Gastroenterology 1992; 102 Suppl.: A77Google Scholar
  79. 79.
    Wang SL, Huang JD, Lai MD, et al. Molecular basis of genetic variation in debrisoquin hydroxylation in Chinese subjects: Polymorphism in RFLP and DNA sequence of CYP2D6. Clin Pharmacol Ther 1993; 53: 410–8PubMedGoogle Scholar
  80. 80.
    Lennard MS, Silas JH, Freestone S, et al. Defective metabolism of metoprolol in poor hydroxylators of debrisoquine. Br J Clin Pharmacol 1982; 14: 301–3PubMedGoogle Scholar
  81. 81.
    Andersson T, Lundborg P, Regårdh CG. Lack of effect of omeprazole treatment on steady-state plasma levels of metoprolol. Eur J Clin Pharmacol 1991; 40: 61–5PubMedGoogle Scholar
  82. 82.
    Henry D, Brent P, Whyte I, et al. Propranolol steady-state pharmacokinetics are unaltered by omeprazole. Eur J Clin Pharmacol 1987; 33: 369–73PubMedGoogle Scholar
  83. 83.
    Ward SA, Walle UK, Wilkinson GR, et al. Propranolol’s metabolism is determined by both mephenytoin and debrisoquin hydroxylase activities. Clin Pharmacol Ther 1989; 45: 72–9PubMedGoogle Scholar
  84. 84.
    Cavanaugh JH, Schneck DW, Mukherji D, et al. Lack of effect of concomitant lansoprazole on single-dose propranolol pharmacokinetics and pharmacodynamics [abstract]. Gastroenterology 1994; 106 Suppl.: A4Google Scholar
  85. 85.
    Koch HJ, Hartmann M, Bliesath H, et al. Pantoprazole does not influence metoprolol pharmacokinetics in man [abstract]. Gastroenterology 1996; 110 Suppl.: A158Google Scholar
  86. 86.
    Guengerich FP, Kim DH, Iwasaki M. Role of human cytochrome P-450 IIE1 in the oxidation of many low molecular weight cancer suspects. Chem Res Toxicol 1991; 4: 168–79PubMedGoogle Scholar
  87. 87.
    Jönsson KÅ, Jones AW, Boström H, et al. Lack of effect of omeprazole, cimetidine, and ranitidine on the pharmacokinetics of ethanol in fasting male volunteers. Eur J Clin Pharmacol 1992; 42: 209–12PubMedGoogle Scholar
  88. 88.
    Roine R, Hernandez-Munoz R, Baraona E, et al. Effect of omeprazole on gastric first-pass metabolism of ethanol. Dig Dis Sci 1992; 37: 891–6PubMedGoogle Scholar
  89. 89.
    Pozzato G, Franzin F, Moretti M, et al. Effects of omeprazole on ethanol metabolism: an in vitro and in vivo rat and human study. Pharmacol Res 1994; 29: 47–58PubMedGoogle Scholar
  90. 90.
    Minocha A, Singh Rahal P, Brier ME, et al. Omeprazole therapy does not affect pharmacokinetics of orally administered ethanol in healthy male subjects. J Clin Gastroenterol 1995; 21: 107–9PubMedGoogle Scholar
  91. 91.
    Girre C, Coutelle C, David P, et al. Lack of effect of lansoprazole on the pharmacokinetics of ethanol in male volunteers [abstract]. Gastroenterology 1994; 106 Suppl.: A504Google Scholar
  92. 92.
    Teyssen S, Singer MV, Heinze H, et al. Pantoprazole does not influence the pharmacokinetics of ethanol in healthy volunteers [abstract]. Gastroenterology 1996; 110 Suppl.: A277Google Scholar
  93. 93.
    Kronbach T, Fischer V, Meyer UA. Cyclosporine metabolism in human liver: Identification of a cytochrome P-450III gene family as the major cyclosporine-metabolizing enzyme explains interactions of cyclosporine with other drugs. Clin Pharmacol Ther 1988; 43: 630–5PubMedGoogle Scholar
  94. 94.
    Watkins PB, Wrighton SA, Maurel P, et al. Identification of an inducible form of cytochrome P-450 in human liver. Proc Natl Acad Sci USA 1985; 82: 6310–4PubMedGoogle Scholar
  95. 95.
    Kerlan V, Dreano Y, Bercovici JP, et al. Nature of cytochromes P450 involved in the 2-/4-hydroxylations of estradiol in human liver microsomes. Biochem Pharmacol 1992; 44: 1745–56PubMedGoogle Scholar
  96. 96.
    Bargetzi MJ, Aoyama T, Gonzales FJ, et al. Lidocaine metabolism in human liver microsomes by cytochrome P450IIIA4. Clin Pharmacol Ther 1989; 46: 521–7PubMedGoogle Scholar
  97. 97.
    Gonzalez FJ, Schmid BJ, Umeno M, et al. Human P450PCN1: sequence, chromosome localization, and direct evidence through cDNA expression that P450PCN1 is nifedipine oxidase. DNA 1988; 7: 79–86PubMedGoogle Scholar
  98. 98.
    Guengerich FP, Miiller-Enoch D, Blair IA. Oxidation of quinidine by human liver cytochrome P-450. Mol Pharmacol 1986; 30: 287–95PubMedGoogle Scholar
  99. 99.
    Blohmé I, Idström JP, Andersson T. A study of the interaction between omeprazole and cyclosporine in renal transplant patients. Br J Clin Pharmacol 1993; 35: 156–60PubMedGoogle Scholar
  100. 100.
    Tateishi T, Graham SG, Krivoruk Y, et al. Omeprazole does not affect measured CYP3A4 activity using the erythromycin breath test. Br J Clin Pharmacol 1995; 40: 411–2PubMedGoogle Scholar
  101. 101.
    Galbraith RA, Michnovicz JJ. Omeprazole fails to alter the cytochrome P450-dependent 2-hydroxylation of estradiol in male volunteers. Pharmacology 1993; 47: 8–12PubMedGoogle Scholar
  102. 102.
    Noble DW, Bannister J, Lamont M, et al. The effect of oral omeprazole on the disposition of lignocaine. Anaesthesia 1994; 49; 497–500PubMedGoogle Scholar
  103. 103.
    Ching MS, Elliott SL, Stead CK, et al. Quinidine single dose pharmacokinetics and pharmacodynamics are unaltered by omeprazole. Aliment Pharmacol Ther 1991; 5: 523–31PubMedGoogle Scholar
  104. 104.
    Meyer BH, Maree JS, Müller FO, et al. Lack of interaction between an oral contraceptive and lansoprazole or omeprazole [abstract]. African Pharmaceutical Society Congress: 1993 Sep 21-24Google Scholar
  105. 105.
    Fuchs W, Sennewald R, Klotz U. Lansoprazole does not affect the bioavailability of oral contraceptives. Br J Clin Pharmacol 1994; 38: 376–80PubMedGoogle Scholar
  106. 106.
    Middle MV, Müller FO, Schall R, et al. Effect of pantoprazole on ovulation suppression by a low-dose hormonal contraceptive. Clin Drug Invest 1995; 9: 54–6Google Scholar
  107. 107.
    Ball SE, Forrester LM, Wolf CR, et al. Differences in the cytochrome P-450 isoenzymes involved in the 2-hydroxylation of oestradiol and 17α-ethinylestradiol. Biochem J 1990; 267: 221–6PubMedGoogle Scholar
  108. 108.
    Cavanaugh JH, Locke C, Karol M. Lack of interaction of lansoprazole or omeprazole with prednisone [abstract]. Am J Gastroenterol 1993; 88: 1589Google Scholar
  109. 109.
    Naidu MUR, Shobha JC, Dixit VK, et al. Effect of multiple dose omeprazole on the pharmacokinetics of carbamazepine. Drug Invest 1994; 7: 8–12Google Scholar
  110. 110.
    Kerr BM, Thummel KE, Wurden CJ, et al. Human liver carbamazepine metabolism, role of CYP3A4 and CYP2C8 in 10,11-epoxide formation. Biochem Pharmacol 1994; 47: 1969–79PubMedGoogle Scholar
  111. 111.
    Böttiger Y, Bertilsson L. No effect on plasma carbamazepine concentration with concomitant omeprazole treatment. Clin Drug Invest 1995; 9: 180–1Google Scholar
  112. 112.
    Rost KL, Brösicke H, Heinemeyer G, et al. Specific and dose-dependent enzyme induction by omeprazole in human beings. Hepatology 1994; 20: 1204–12PubMedGoogle Scholar
  113. 113.
    Reill L, Erhardt F, Fischer R, et al. Effect of oral pantoprazole on 24-h intragastric pH, serum gastrin profile and drug metabolizing enzyme activity in man — a placebo-controlled comparison with ranitidine [abstract]. Gut 1993; 34 Suppl.: 63Google Scholar
  114. 114.
    Clark DWJ. Genetically determined variability in acetylation and oxidation. Drugs 1985; 29: 342–75PubMedGoogle Scholar
  115. 115.
    Gustavson LE, Kaiser JF, Edmonds AL, et al. Effect of omeprazole on concentrations of clarithromycin in plasma and gastric tissue at steady state. Antimicrob Agents Chemother 1995; 39: 2078–83PubMedGoogle Scholar

Copyright information

© Adis International Limited 1997

Authors and Affiliations

  • Peter Unge
    • 1
  • Tommy Andersson
    • 2
  1. 1.Department of MedicineSandviken HospitalSandvikenSweden
  2. 2.Astra Hässle ABMölndalSweden

Personalised recommendations