Pantoprazole 40 mg + Domperidone 10 mg
Pantoprazole is a proton pump inhibitor (PPI) that suppresses the final step in gastric acid production by
covalently binding to the (H + / K + )-ATPase enzyme system at the secretory surface of the gastric parietal cell.
This effect leads to inhibition of both basal and stimulated gastric acid secretion irrespective of the stimulus.
The binding to the (H + /K + )-ATPase results in a duration of antisecretory effect that persists longer than 24
hours for all doses.
Domperidone is a potent dopamine receptor (D2) antagonist. It increases motility of GI tract by inhibiting the
action of dopamine and fastens gastric emptying. Domperidone increases Lower esophageal sphincter
pressure and prevent reflux of stomach content into esophagus. Domperidone also inhibits the D2 receptor
in the chemoreceptor trigger zone thereby it prevents nausea and vomiting.
RATIONALE OF COMBINATION
The mode of action of both Pantoprazole and Domperidone are different and complimentary to each other.
Upper G.I. disorders are frequently associated with a combination of hyperacidity and dysmotility. As a result,
acidic chyme may either stagnate in stomach and duodenum or may be evacuated by reverse peristalsis
(vomiting or nausea).
Reflux of acid contents of stomach cause erosions of lower part of esophagus which may further aggravate
nausea and vomiting. Since both hyperacidity and dysmotility are present at the same time in disorders like
Gastro Esophageal Reflux Disease (GERD) and Non Ulcer Dyspepsia (NUD), a combination of drugs which will
take care of both would be ideal.
Pantoprazole is a potent gastric acid inhibitor that blocks the final stage of acid secretion. Hence, whatever
may be the stimulus; hyperacidity will be controlled by Pantoprazole.
In contrast, Domperidone increases G.I. motility, thereby facilitating the movement of acid contents further
down in the intestine preventing reflux esophagitis and thereby controlling nausea and vomiting.
Hence, the pharmacology of Pantoprazole and Domperidone corroborates their use in combined form for the
treatment of GERD, NUD and related disorders.
ii.) Erosive esophagitis
iii.) Non ulcer dyspepsia