Update on Prescribing Information for Pantoprazole

to the editor: This letter is in response to the article, “Proton Pump Inhibitors: An Update.”¹ Pantoprazole (Protonix) was approved by the U.S. Food and Drug Administration (FDA) for the acute treatment of erosive esophagitis in February 2000 and for the maintenance of healing of erosive esophagitis in June 2001.² Additionally, both oral and intravenous formulations received approval by the FDA for the treatment of pathologic hypersecretory conditions.^2,3

The article¹ contained a few inaccuracies in the review of drug interactions for pantoprazole. In the review,¹ pantoprazole was documented to have an unknown effect on clarithromycin (Biaxin) and increase the absorption of digoxin and nifedipine (Procardia). As per the current prescribing information, pantoprazole has no clinically relevant drug interactions with clarithromycin, digoxin, or nifedipine.^2,3 We have provided this information so that your readers have the most accurate information on pantoprazole.

in reply: We appreciate the comments of Dr. Karlstadt and Ms. Walker concerning the drug interactions for pantoprazole (Protonix). In our article,¹ pantoprazole was noted to have an unknown effect on clarithromycin (Biaxin) and to increase the absorption of digoxin and nifedipine (Procardia) based on information in two articles.^2,3 These interactions may not be clinically relevant as is mentioned in the package insert for pantoprazole. Nevertheless, we believed it is prudent to share this information with family physicians who are frequently faced with the daunting task of managing a patient who is receiving a large number of medications, often in clinical situations unlike those typically included in drug trials.