Effect of food on the pharmacokinetics of omeprazole, pantoprazole and rabeprazole

Background The pharmacokinetics of proton pump inhibitors (PPIs) may be affected by food intake. We aimed to evaluate the effect of food on the pharmacokinetics of omeprazole, rabeprazole, and pantoprazole. Setting The study population comprised 186 healthy volunteers participating in 6 bioequivalence clinical trials. Method Subjects were evaluated to determine the effect of a high-fat breakfast on the pharmacokinetics of omeprazole (n = 36), rabeprazole (n = 69), and pantoprazole (n = 81). Main outcome measure Drug plasma concentrations were measured using high-performance liquid chromatography coupled to mass spectrometry. Results Food affected the pharmacokinetics of omeprazole (increased T(max)and decreased AUC and C-max), pantoprazole (increased T(max)and decreased AUC), and rabeprazole (increased T-max, C(max)and half-life). Food increased variability in T(max)for all 3 drugs, delaying absorption around 3 to 4 h and until 20 h in some subjects. Conclusion As food delays the absorption of PPIs and increases their variability, it would be better to administer these drugs under fasting conditions.