Rationale of Combination: Pantoprazole + Domperidone
Product Description: Pantoprazole is a substituted benzimidazole indicated for the short-term treatment (up to 16 weeks) in the healing and symptomatic relief of erosive esophagitis whereas Domperidone is a specific blocker of dopamine receptors. It speeds gastrointestinal peristalsis, causes prolactin release, and is used as antiemetic and tool in the study of dopaminergic mechanisms. Pantoprazole with Domperidone is used to reduce the amount of acid produced by the stomach, to treat or prevent conditions such as heartburn, Gastritis, ulcers and GERD. For best results, it should be taken just before a meal. It can help with the greater amount of stomach acid that is always produced.
Pantoprazole: Pantoprazole is a proton pump inhibitor (PPI) that suppresses the final step in gastric acid production. Pantoprazole is unstable in acid and is administered orally in the form of an enteric-coated tablet Pantoprazole is completely and rapidly absorbed after oral administration. The absolute bioavailability from the tablet was found to be about 77 %. Pantoprazole is extensively metabolized in the liver through the cytochrome P450 (CYP) system. Renal elimination represents the major route of excretion (about 80%) for the metabolites of Pantoprazole; the rest is excreted with the faeces.
Domperidone: Domperidone acts as a gastrointestinal emptying (delayed) adjunct and peristaltic stimulant. The gastroprokinetic properties of Domperidone are related to its peripheral dopamine receptor blocking properties.. In fasting subjects, Domperidone is rapidly absorbed after oral administration. Domperidone is 91-93% bound to plasma proteins. Domperidone undergoes rapid and extensive hepatic metabolism and Urinary and faecal excretions amount to 31 and 66% of the oral dose respectively.
Precautions: ●Pantoprazole is not recommended for children less than 12years. ●Caution should be exercised in patients with history of liver disease, any other gastrointestinal disorders, any allergy and during pregnancy. ●Avoid prolonged usage of this medication. ●It may cause dizziness, do not drive a car or operate machinery while taking this medication.
Contraindications: Pantoprazole is contraindicated in heptic impairment; hypersensitivity. Domperidone is contraindicated in the history of hypersensitivity to dimenhydrinate or related compounds.
Drug Interactions: Pantoprazole may reduce the absorption of active substances whose bioavailability is dependent on the gastric pH (e.g. ketoconazole). Pantoprazole is metabolized in the liver via the cytochrome P450 enzyme system. An interaction of Pantoprazole with other substances which are metabolized by the same enzyme system cannot be excluded. The main metabolic pathway of Domperidone is through CYP3A4. In vitro data suggest that the concomitant use of drugs that significantly inhibit this enzyme may result in increased plasma levels of Domperidone.
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