4 known interactions • 1 major • 2 moderate • 1 minor
Always disclose all medications to your healthcare providers — prescription medicines, OTC medications, vitamins, and herbal supplements. This list may not include every possible interaction. Use our Medicine Interaction Checker to screen your complete medication list.
Potentially life-threatening or causing permanent damage. Avoid combination.
May worsen condition or require dose adjustment. Monitor closely.
Usually limited clinical effect. Manage with routine monitoring.
HIV antiretrovirals (atazanavir, rilpivirine, nelfinavir)
Elevated gastric pH significantly reduces absorption of pH-dependent antivirals.
Management: Contraindicated with atazanavir and rilpivirine. Separate other antivirals and monitor levels.
Methotrexate
PPIs raise gastric pH and may reduce methotrexate clearance, increasing methotrexate toxicity.
Management: Consider temporarily stopping PPI during high-dose methotrexate therapy; monitor carefully.
Ketoconazole / itraconazole
These antifungals require acidic environment for absorption; PPIs reduce their bioavailability.
Management: Avoid combination or use alternative antifungal not requiring acidic pH.
Clopidogrel
Unlike omeprazole, pantoprazole has minimal inhibition of CYP2C19 and is less likely to reduce the antiplatelet effect of clopidogrel. It is the preferred PPI when concomitant clopidogrel use is necessary.
Always ask your pharmacist about potential interactions with food, alcohol, and supplements specific to Pantoprazole. Some medicines have significant interactions with grapefruit juice, high-fat meals, dairy products, or vitamin K-rich foods.