Pantoprazole

Overview

Pantoprazole, sold under the brand name Protonix, among others, is a proton pump inhibitor medication used for the treatment of stomach ulcers, short-term treatment of erosive esophagitis due to gastroesophageal reflux disease (GERD), maintenance of healing of erosive esophagitis, and pathological hypersecretory conditions including Zollinger–Ellison syndrome. It may also be used along with other medications to eliminate Helicobacter pylori. Pantoprazole is a proton-pump inhibitor (PPI) and its effectiveness is similar to that of other PPIs. It is available by mouth and by injection into a vein.[1–4] WP

Common side effects include headaches, diarrhea, abdominal pain, and joint pain. More serious side effects may include severe allergic reactions, a type of chronic inflammation known as atrophic gastritis, Clostridioides difficile colitis, low magnesium, and vitamin B12 deficiency. Use in pregnancy appears to be safe. Pantoprazole is a proton pump inhibitor that decreases gastric acid secretion. It works by inactivating (H+/K+)-ATPase function in the stomach.[1][2][5] WP

The study of pantoprazole began in 1985, and it came into medical use in Germany in 1994. It is available as a generic medication. In 2023, it was the thirteenth most commonly prescribed medication in the United States, with more than 37 million prescriptions. In Australia, it was one of the top 10 most prescribed medications between 2017 and 2023.[1][6–10] WP

Uses, dosage and effects

Medical uses

Pantoprazole is used for short-term treatment of erosion and ulceration of the esophagus for adults and children five years of age and older caused by gastroesophageal reflux disease. It can be used as a maintenance therapy for long-term use after initial response is obtained, but there have not been any controlled studies about the use of pantoprazole past a duration of 12 months. Pantoprazole may also be used in combination with antibiotics to treat ulcers caused by Helicobacter pylori. It can also be used for long-term treatment of Zollinger-Ellison syndrome. It may be used to prevent gastric ulcers in those taking NSAIDs.[3][11][12] WP

For improved efficacy of pantoprazole, the oral tablet formulation is taken half an hour prior to ingestion of food. In the hospital, intravenous administration is indicated when patients are unable to take the medication by mouth.[2][13] WP

Children

Pantoprazole is only indicated for the short-term treatment of erosive esophagitis in children ages seven and older; and the safety and effectiveness of pantoprazole have only been established in the treatment of erosive esophagitis in children.[11] WP

Long-term use

• Osteoporosis and bone fracture have been observed in people on high-dose and/or long-term (over one year) prescription proton pump inhibitors.[14] WP
• Hypomagnesia has been observed in people on medications like pantoprazole when taken for longer periods of time (generally one year or more, although cases have been reported with regimens as short as three months).[15] WP
• Deficiencies such as vitamin B12 deficiency, iron deficiency, and calcium deficiency may be seen with long term use. Vitamin B12 deficiency is due to the change in the acidic environment within the stomach with the use of pantoprazole which prevents peptidases from being activated. This prevents the cleaving of R-factor from vitamin B12 and prevents its absorption.[2][16] WP
• Rebound hypergastrinemia may be seen when stopping the medication after long term use.[16][17] WP

Veterinary use

In veterinary medicine, pantoprazole appears to be safe to use in several large animal species. The pharmacokinetics of pantoprazole have been explored in several veterinary species, including calves, alpacas and foals with half lives reported as 2.81, 0.47, and 1.43 hours, respectively. Pantoprazole appears to be eliminated more quickly in goats when compared to calves, with goats having an elimination half-life of less than one hour.[18–22] WP

Pantoprazole has been demonstrated to increase the 3rd compartment pH in alpacas. It has been shown to be generally safe to use in cattle, sheep and goats. The subcutaneous bioavailability is greater than 100% in calves. In calves intravenous and subcutaneous administration has been shown to significantly elevate abomasal pH.[18][21][23] WP

Risks and side effects

Infection

Stomach acid plays a role in killing ingested bacteria. Use of pantoprazole may increase the chance of developing infections such as pneumonia, particularly in hospitalized patients.[24] WP

Elderly

The incidence of adverse effects occurring in people aged 65 years and older was similar to that in people aged 65 years and less.[11] WP

Pregnancy

In reproductive studies using doses largely greater than the recommended doses performed on rats and rabbits, there was no evident harm on the development of the baby.[11][25] WP

Breast feeding

Pantoprazole has been found to pass through the breast milk. Additionally, in rodent cancer studies, pantoprazole has been shown to potentially cause tumor growth. The clinical relevance of the finding is unknown, but risks and benefits are recommended for consideration in determining the use of therapy for the mother and child.[11][25] WP

Common

• Gastrointestinal: abdominal pain (6%), diarrhea (9%), flatulence (4%), nausea (7%), vomiting (4%)[11] WP
• Neurologic: headache (12%), dizziness (3%)[11] WP
• Neuromuscular and skeletal: arthralgia (3%)[11] WP

Rare

• Gastrointestinal: constipation, dry mouth, hepatitis[11] WP
• Blood problems: low white blood cell count, thrombocytopenia[11] WP
• Immunologic: Stevens–Johnson syndrome, toxic epidermal necrolysis[11] WP
• Metabolic: elevated creatine kinase, elevated cholesterol levels, elevated liver enzymes (AST/ALT), swelling[11] WP
• Musculoskeletal: Muscle disorders, bone fracture and infection, Clostridioides difficile infection, osteoporosis-related hip fracture, rhabdomyolysis[11] WP
• Kidneys: interstitial nephritis[26] WP
• Nutrition: may reduce the absorption of important nutrients, vitamins, and minerals, including certain medications, leaving users at increased risk for pneumonia.[27] WP

Discontinuation

In people taking PPIs for longer than six months, a dose taper is recommended prior to discontinuation.[28] WP

Interactions

Interactions

Due to its effect of reducing stomach acidity, use of pantoprazole can affect absorption of drugs that are pH-sensitive, such as ampicillin esters, ketoconazole, atazanavir, iron salts, amphetamine and mycophenolate mofetil. Additional medications that are affected include bisphosphonate derivatives, fluconazole, clopidogrel, and methotrexate.[2][11] WP

Pharmacology

Pharmacology

The mechanism of action of pantoprazole is to inhibit the final step in gastric acid production. In the gastric parietal cell of the stomach, pantoprazole covalently binds to the H+/K+ ATP pump to inhibit gastric acid and basal acid secretion. The covalent binding prevents acid secretion for up to 24 hours and longer.[11] WP

Pantoprazole is metabolized in the liver by the cytochrome P450 system. Metabolism mainly consists of demethylation by CYP2C19 followed by sulfation. Another metabolic pathway is oxidation by CYP3A4. Pantoprazole metabolites are not thought to have any pharmacological significance. It is usually given with a prokinetic drug because of inactivity in the acidic environment of the stomach. Pantoprazole binds irreversibly to H+K+ATPase (proton pumps) to suppress the secretion of acid. Due to irreversible binding of the pumps, new pumps have to be made before acid production can be resumed. The drug's plasma half-life is about two hours. After administration, the time for the drug to reach peak plasma concentrations is 2 to 3 hours. The percentage of the drug that is protein bound is 98%.[5][13][29][30] WP

History

History

Pantoprazole was discovered by scientists at Byk Gulden, a subsidiary of Altana; the drug discovery program started in 1980, producing pantoprazole in 1985. The compound was actually created by chemists working to scale up a different chemical that had been chosen as a development candidate. Byk Gulden partnered with Smith Kline & French in 1984. The compound's development names were BY1029 and SK&F96022. By 1986 the companies had created the sodium salt, pantoprazole sodium sesquihydrate, and decided to develop it as it was more soluble and stable, and was more compatible with other ingredients used in the formulation. It was first marketed in Germany in 1994. Wyeth licensed the US patent from Altana, and obtained marketing approval from the US FDA in 2000 under the trade name Protonix.[31–34] WP

In 2004, worldwide sales of the drug were $3.65 billion, about half of which were in the US.[32] WP

In 2007, Altana's drug business was acquired by Nycomed. Nycomed was in turn acquired by Takeda in 2011 and Wyeth was acquired by Pfizer in 2009.[35][36][37] WP

The patent protecting the drug was set to expire in 2010, but Teva Pharmaceuticals filed an Abbreviated New Drug Application (ANDA) in 2007, and Wyeth and Nycomed sued Teva for patent infringement, but Teva decided to launch its generic drug "at risk" that year, before the patent had been invalidated. Wyeth launched an authorized generic in 2008. Pfizer and Takeda's patent exclusivity expired in 2010, and an administrative exclusivity they had for pediatric use expired in January 2011, and full generic competition began. The litigation between Teva and Pfizer/Takeda was settled in 2013, with Teva paying the patent holders $2.15 billion in damages for its early launch.[35][38–41] WP

Legal status

Society and culture

As of 2017, the drug was marketed under many brands worldwide, including as a combination drug with domperidone, a combination with itopride, in combination with both clarithromycin and amoxicillin, in combination with levosulpiride, and in combination with naproxen.[42] WP

As of 2017, it was marketed under many brands worldwide, including: Acernix, Aciban, Acida, Acido-X, Acidrol, Acidwell, Acilib, Acilibre, Acillect, Acipan, Acrid, Alapanzol, Amphoter, Anagastra, Anesteloc, Antaxid, Antopral, Anulacid, Anxel, Apazol, Appryo, Aptizole, Apton, Armcid, Asoprazole, Aspan, Aurizol-P, Awamed, Azatol, Biotop V, Brandocare, Branzol, Buffet, Buscopan Reflusso, Caprol, Ciprazol, Citrel, Clessol, Comenazol, Conoran, Contix, Contracid, Contraflux, Contro-Cap, Controloc, Cool Pan, Delpanto EC, Digene Total, Digespan, Dosanloc, Empaflun, Eracid, Erprazol, Esopan, Eupantol, Exopan, Extream, Extreme, F-Pan, Farmazol, Fenix, Fexmor, Fu Shi Tan, Fulpan, Fupan, Gastblok, Gastenz, Gastrazol-L, Gastriwin, Gastrolan, Gastroloc, Gastromax, Gastronorm, Gastroprozal, Gastrostad, Gastrowell, Gastrozol, Gerdamegh, Gerprazol, Gesoflux, Gondea, Gopan, Hansazol, Hasanloc, Helix, Iboprot, Inipant, Inipepsia, Inipomp, IPP, Ippracid, Ipraalox, Kaiji, Kairol, Letopra, Loxanto, Luoxu, Lupipan, Maalox, Mag, Manez, Marozel, Monpan, Nelgast, Nexpan, Noacid, Noacid, Nolpaza, Normogastrol, Noxadif, Ntap, Nuosen, Nupenta, Oritop, Osipan, Ozepran, Ozpan, Ozzion, P-20, P-40, P-Bit, P-OD, P-PPI, P-Zole, Pacid, Paciddia, Palio, Palmy, Pamel, Pamtrazol, Pamyl, Pan, Panbloc, Pancleus, Pancrazio, Pandev, Pane, Panfast, Pangest, Panglen, Panlan, Panlisu, Panloc, Panloz, Panmeilu, Panocer, Panogastin, Panopaz, Panor, Panoral, Panore, Panpot, Panpra, Panprabene, Panprax, Panprazol, Panprazox, Panpro, Panproton, Panpure, Panrazol, Panrazole, Panrbe, Panref, Pansa, Pansec, Panso, Pantac, Pantacid, Pantact, Pantagi, Pantakind, Pantaltius, Pantap, Pantasur, Pantaz, Pantazol, Pantecta, Pantex, Pantexel, Pantezol, Panthec, Panthron, Pantid, Pantin, Pantip, Pantium, Panto, Panto-Denk, Panto-Gas, Pantobex, Pantoc, Pantocal, Pantocar, Pantocare, Pantocas, Pantocer, Pantocid, Pantocim, Pantocom, Pantocure, Pantodac, Pantodar, Pantofin, Pantofir, Pantogastrix, Pantogen, Pantogerolan, PantoJenson, Pantokem, Pantokool, Pantolax, Pantoline, Pantoloc, Pantolok, Pantolup, Pantomax, Pantomed, Pantometylentina, Pantomyl, Pantonis, Pantonix, Pantop, Pantopacid, Pantopan, Pantopaz, Pantopep, Pantopi, Pantopra-Q, Pantopraz, Pantoprazal, Pantoprazol, Pantoprazole, Pantoprazolo, Pantoprazolum, Pantoprem, Pantoprix, Pantoprol, Pantopump, Pantor, Pantorc, Pantoren, Pantorica, Pantosal, Pantosan, Pantosec, Pantosid, Pantostad, Pantotab, Pantotis, Pantover, Pantoz, Pantozim, Pantozol, Pantozole, Pantpas, Pantra, Pantrol, Pantroz, Pantul, Pantune, Pantus, Panveda, Panvell, Panz, Panzat, Panzel, Panzilan, Panzilan, Panzol, Panzole, Panzor, Parastamic, Paz, Peblo, Penkool, Penlip, Pentalink, Pentastar, Pentowin, Pentoz, Pentozed, Peploc, Peptac, Peptazol, Peptazole, Pepticaid, Pepticool, Peptix, Peptoloc, Pepzol, Perloc, Pipanzin, Pozola, Praize, Pranza, Praz-Up, Prazobloc, Prazocid, Prazolacid, Prazolan, Prazole, Prazolpan, Prazopant, Pregel, Prevacid, Previfect, Previfect, Progen, Prolex, Promtec, Propanz, Protech, Protinum, Protium, Protocent, Protocid, Protofix, Protoloc, Proton, Proton-P, Protonex, Protonil, Protonix, Protopan, PTA, Pulcet, Pumpisel, Ranloc, Razon, Rcpan, Redacib, Refluxine, Refluxopan, rifun, Ripane, Roxitrol, Sedipanto, Segregam, Seltraz, Sipar, Sodac, Somac, Sozol, Stamic, Stomafor, Stripole, Sumipral, Supacid, Super OM, Suppi, Supracam, Supracid, Surmera, Tai Mei Ni Ke, Tecta, Tonval, Topazol, Topra, Topraz, Topzole, Toraflux, Tropaz, Trupan, Ulceron, Ulcoreks, Ulcotenal, Ulprix, Ulsepan, Ulstop, Ultop, Ultoz, Unigastrozol, Vencid, Ventro-Pant, Vomizole, Wei Di, Wei Ke An, Wonon, Xotepic, Yoevid, Zamotil, Zaprol, Zencopan, Zgaton, Zimpax, Zipant, Zipantol, Zipantola, Ziprol, Zolan, Zolemer, Zolpan, Zolpanz, Zolpra, Zoltex, Zoltum, Zontop, Zoprax, Zovanta, Zurcal, and Zurcazol.[42] WP⚠ Part of this sentence could not be copied from the source. Open the source to read it in full.

It was marketed as a combination drug with domperidone under the brand names Aciban-DSR, Acillect-DSR, Asoprazole-D, Buffet-DXR, Depam, Domelong P, Dycizol, Eracid-D, F-Pan DSR, Fulpan-D, Fulpan-DSR, Gerdom, Gi-Fri, Gopan-D, Gopan-DSR, GR8-OD, Kurepane-DSR, Latop-D, Monpan-D, Monpan-DSR, Nupenta-DSR, Odipan-DSR, Oritop-D, Oritop-DSR, P-Bit-D, P-Bit-DSR, P-Zole DSR, P-Zole-D, PAA-DSR, Palio-D, Pamtrazol-D, Pan-D, Pancrazio-DSR, Pandiff, Pandostal, Pandostal-OD, Panfast-DSR, Panopaz-D, Panor-D, Panpot-DSR, Pansa-D, Pantact-D, Pantin-D, Pantin-RD, Pantocar-D, Pantocom-D, Pantoflux, Pantojoy-DXR, Pantokool-D, Pantolex-DS, Pantopacid-D, Pantopacid-SR, Pantorica-D, Pantozol-D, Pantozol-DSR, Pantra-D, Pantune-D, Panveda-D, Panzo-D, Panzol Plus, Panzol-D, Paz-DN, Peblo-D, Peblo-DSR, Penkool-DSR, Penlip-D, Pentalink-D, Pentastar-D, Pentozed-D, Peptac D, Peptac DSR, Pepticool-DXR, Pintel-DSR, Pop-DSR, Praize-D, Praize-D Forte, Prazole Plus, Prazosan-DSR, Predom, Predom-OD, Prolex-DSR, Prolus-DSR, Protocent-DSR, Protopan-D, Protopan-H, Ripane-D, Ripane-DSR, Trazol-DSR, PTA-D, Ulcicap-PD, Ultop DSR, Ultoz-D, Wonon-D, Wonon-DSR, and Zovanta-D.[42] WP

It was marketed in combination with itopride under the brand names Ganaton Total, Kurepan-IT, Nupenta-ITR, P-Bit-ISR, Pepnil-ITO, Prolus-ISR, and Protopan-I.[42] WP

It was marketed in combination with clarithromycin and amoxicillin as Gastrocomb, Klacid Hp7, Panclamox, and ZacPac.[42] WP

It was marketed in combination with levosulpiride as Panlife-LS and in combination with naproxen as Arthopan.[42] WP⚠ Part of this sentence could not be copied from the source. Open the source to read it in full.

Chemistry

Formula

C16H15F2N3O4S PC

CAS number

102625-70-7 PC

Molar mass (g/mol)

383.4 PC

IUPAC name (computed by PubChem)

6-(difluoromethoxy)-2-[(3,4-dimethoxy-2-pyridinyl)methylsulfinyl]-1H-benzimidazole PC

SMILES

COC1=C(C(=NC=C1)CS(=O)C2=NC3=C(N2)C=C(C=C3)OC(F)F)OC PC

InChIKey

IQPSEEYGBUAQFF-UHFFFAOYSA-N PC

PubChem CID

4679

Harm reduction information

No harm reduction data is on file for this compound yet. That means no dose, timing or combination data from PsychonautWiki or TripSit. Please don't guess a dose from similar compounds. If you have taken it and feel unwell, contact emergency services or a poison control center.

User reports

Pop culture

No references added yet.

Sources

1. Other Pantoprazole Sodium Monograph for Professionals - Drugs.com
2. Journal / agency Bernshteyn MA, Masood U. StatPearls. 2022. PMID 29763120
3. Other British national formulary: BNF 74. 2017
4. Other 99 Comparative effectiveness of proton pump inhibitors. 28 June 2016
5. Journal / agency Richardson P, Hawkey CJ, Stack WA. Proton pump inhibitors. Pharmacology and rationale for use in gastrointestinal disorders. Drugs. September 1998. doi:10.2165/00003495-199856030-00002 · PMID 9777309
6. Other Fischer J, Ganellin CR. Analogue-based Drug Discovery. 2006
7. Journal / agency Pantoprazole: FDA-Approved Drugs
8. Other Top 300 of 2023
9. Other Pantoprazole Drug Usage Statistics, United States, 2014 - 2023
10. Other Medicines in the health system. 2 July 2024
11. Journal / agency Protonix delayed-release- pantoprazole sodium tablet, delayed release Protonix delayed-release- pantoprazole sodium granule, delayed release. 2 May 2019
12. Journal / agency Dammann HG, Fölsch UR, Hahn EG, von Kleist DH, Klör HU, Kirchner T, Strobel S, Kist M. Eradication of H. pylori with pantoprazole, clarithromycin, and metronidazole in duodenal ulcer patients: a head-to-head comparison between two regimens of different duration. Helicobacter. March 2000. doi:10.1046/j.1523-5378.2000.00006.x · PMID 10672051
13. Journal / agency Strand DS, Kim D, Peura DA. 25 Years of Proton Pump Inhibitors: A Comprehensive Review. Gut and Liver. January 2017. doi:10.5009/gnl15502 · PMID 27840364 · PMC5221858
14. Journal / agency Center for Drug Evaluation and Research. Postmarket Drug Safety Information for Patients and Providers - FDA Drug Safety Communication: Possible increased risk of fractures of the hip, wrist, and spine with the use of proton pump inhibitors
15. Journal / agency Center for Drug Evaluation and Research. Drug Safety and Availability - FDA Drug Safety Communication: Low magnesium levels can be associated with long-term use of Proton Pump Inhibitor drugs (PPIs)
16. Journal / agency Ahmed A, Clarke JO. StatPearls. 2022. PMID 32491317
17. Journal / agency Seifert R. Basic Knowledge of Pharmacology. 2019. doi:10.1007/978-3-030-18899-3_13
18. Journal / agency Smith JS, Kosusnik AR, Mochel JP. A Retrospective Clinical Investigation of the Safety and Adverse Effects of Pantoprazole in Hospitalized Ruminants. Frontiers in Veterinary Science. 2020. doi:10.3389/fvets.2020.00097 · PMID 32258063 · PMC7089877
19. Journal / agency Olivarez JD, Kreuder AJ, Tatarniuk DM, Wulf LW, Dembek KA, Mochel JP, Smith JS. Pharmacokinetics and Tissue Levels of Pantoprazole in Neonatal Calves After Intravenous Administration. Frontiers in Veterinary Science. 2020. doi:10.3389/fvets.2020.580735 · PMID 33330703 · PMC7728716
20. Journal / agency Ryan CA, Sanchez LC, Giguère S, Vickroy T. Pharmacokinetics and pharmacodynamics of pantoprazole in clinically normal neonatal foals. Equine Veterinary Journal. July 2005. doi:10.2746/0425164054529427 · PMID 16028623
21. Journal / agency Smith GW, Davis JL, Smith SM, Gerard MP, Campbell NB, Foster DM. Efficacy and pharmacokinetics of pantoprazole in alpacas. Journal of Veterinary Internal Medicine. July 2010. doi:10.1111/j.1939-1676.2010.0508.x · PMID 20384953
22. Journal / agency Smith JS, Mochel JP, Soto-Gonzalez WM, Rahn RR, Fayne BN, Escher OG, Geletka AM, Harvill LE, Bergman JB, Cox S. Pharmacokinetics of Pantoprazole and Pantoprazole Sulfone in Goats After Intravenous Administration: A Preliminary Report. Frontiers in Veterinary Science. 2021. doi:10.3389/fvets.2021.744813 · PMID 34631865 · PMC8492921
23. Journal / agency Olivarez JD, Mulon PY, Ebner LS, Cremerius H, Cantrell C, Rahn R, Soto-Gonzalez W, Bergman J, Cox S, Mochel JP, Kreuder AJ, Smith JS. Pharmacokinetic and pharmacodynamic properties of pantoprazole in calves. Frontiers in Veterinary Science. 30 January 2023. doi:10.3389/fvets.2022.1101461 · PMID 36794231 · PMC9923100
24. Journal / agency Herzig SJ, Doughty C, Lahoti S, Marchina S, Sanan N, Feng W, Kumar S. Acid-suppressive medication use in acute stroke and hospital-acquired pneumonia. Annals of Neurology. November 2014. doi:10.1002/ana.24262 · PMID 25164323 · PMC4214881
25. Other Pantoprazole Use During Pregnancy. 26 June 2018
26. Journal / agency Ricketson J, Kimel G, Spence J, Weir R. Acute allergic interstitial nephritis after use of pantoprazole. CMAJ. March 2009. doi:10.1503/cmaj.080456 · PMID 19255077 · PMC2645468
27. Other Ackerman T. Acid reflux drugs may lead to heart disease, says Houston study. 10 July 2013
28. Journal / agency Wolfe MM, Sachs G. Acid suppression: optimizing therapy for gastroduodenal ulcer healing, gastroesophageal reflux disease, and stress-related erosive syndrome. Gastroenterology. February 2000. doi:10.1016/s0016-5085(00)70004-7 · PMID 10868896
29. Journal / agency Meyer UA. Metabolic interactions of the proton-pump inhibitors lansoprazole, omeprazole and pantoprazole with other drugs. European Journal of Gastroenterology & Hepatology. October 1996. doi:10.1097/00042737-199610001-00005 · PMID 8930576
30. Journal / agency Sachs G, Shin JM, Hunt R. Novel approaches to inhibition of gastric acid secretion. Current Gastroenterology Reports. December 2010. doi:10.1007/s11894-010-0149-5 · PMID 20924727 · PMC2974194
31. Other Senn-Bilfinger J, Sturm E. Analogue-based drug discovery. 2006
32. Other Daly EM. Wyeth, Nycomed Take Aim At Sandoz Over Protonix. 20 May 2008
33. Journal / agency Mathews S, Reid A, Tian C, Cai Q. An update on the use of pantoprazole as a treatment for gastroesophageal reflux disease. Clinical and Experimental Gastroenterology. 2010. doi:10.2147/ceg.s6355 · PMID 21694841 · PMC3108659
34. Journal / agency Drug Approval Package: Protonix (Pantoprazole Sodium) NDA 20987. 24 December 1999
35. Other Goldstein J. Generic Protonix and Wyeth as Takeover Bait. 30 January 2008
36. Other Takeda to Buy Nycomed for $13.7 Billion. 19 May 2011
37. Other Davis A. Pfizer in talks to acquire Wyeth in $60 billion deal: WSJ. 23 January 2009
38. Other Saul S. Wyeth Faces Generic Rival to a Heartburn Drug. 7 September 2007
39. Journal / agency Curtiss FR. Perspectives on the "generic cliff"--pushing and falling. Journal of Managed Care Pharmacy. April 2008. doi:10.18553/jmcp.2008.14.3.318 · PMID 18439056 · PMC10438035
40. Other Protonix - Big Patent Expirations of 2010
41. Other Helfand C. Teva loses $2B gamble on generic of Pfizer's Protonix. 12 June 2013
42. Other Pantoprazole international brand names

Text and values on this page are quoted from Wikipedia (CC BY-SA 4.0), PubChem (public domain). Each value links to the exact revision it came from.