CYP50 inhibition is least by:
(A) Pantoprazole (B) Rabeprazole (C) Lansoprazole (D) Omeprazole
(B) Ans: B. Rabeprazole(Ref: Goodman Gilman 12/e p1990; Katzung131e p1060, 12/e p1089; KDT 7/e p653).Rabeprazole:Exclusively metabolized by CYP2C19 and does not cause any inhibition of CYP450.Highest efficacy.Lansoprazole - Most potent.Rabeprazole & pantoprazole have no significant drug interactions.The FDA has issued a warning about a potentially impoant adverse interaction between clopidogrel and proton pump inhibitors.Proton pump inhibitors should be prescribed to patients taking clopidogrel only if they have an increased risk of gastrointestinal bleeding or require them for chronic gastro-esophageal reflux or peptic ulcer disease, in which case agents with minimal CYP2C19 inhibition (pantoprazole or rabeprazole) are preferred