Pantoprazole: from drug metabolism to clinical relevance.
BACKGROUND
Conditions requiring inhibition of acid secretion, such as gastro-oesophageal reflux disease (GORD), peptic ulcers, non-ulcer dyspepsia or the use of NSAIDs, are very common, and their prevalence is expecting to rise as they are seen predominantly amongst the elderly. Among the drugs available to inhibit acid secretion, proton pump inhibitors (PPI) have been shown to have the best efficacy-safety ratio and have been used widely.


OBJECTIVE
This paper was intended to provide an overall presentation of one of these PPIs, pantoprazole.


METHODS
This study was first intended to give an overview of pantoprazole, so a Medline search was conducted using pantoprazole as unique search term, without publication date restriction. We found 826 references for pantoprazole and selected some of the most relevant publications to conduct this review.


CONCLUSIONS
Five different PPIs are commercially available: omeprazole, pantoprazole, rabeprazole, lansoprazole and esomeprazole. Pantoprazole differs from other PPIs by a selective binding to the ion transport pathway, a good stability at neutral pH values, and a relatively robust plasma concentration-time curve. These pharmacokinetic differences may not be fully converted into pharmacodynamic differences of pantoprazole versus other PPIs. Pantoprazole has been assessed in most of the clinical situations where acid suppression is required, and showed great efficacy and an excellent safety profile. Some safety concerns were raised with long-term use of PPIs, but they are well balanced by the benefit of PPIs for patients with conditions such as GORD or peptic ulcer.
Bardou
Marc
M
Centre d'Investigations Cliniques, CHU de Dijon, France. Marc.Bardou@u-bourgogne.fr
Martin
Janet
J
D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000378:metabolism / Q000627:therapeutic use*; D000897:Anti-Ulcer Agents / Q000378:metabolism / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D005764:Gastroesophageal Reflux / Q000188:drug therapy; D006801:Humans; D000077402:Pantoprazole; D010437:Peptic Ulcer / Q000188:drug therapy; D054328:Proton Pump Inhibitors / Q000378:metabolism / Q000627:therapeutic use*; D016896:Treatment Outcome
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000897:Anti-Ulcer Agents; D054328:Proton Pump Inhibitors; D000077402:Pantoprazole