Drug interactions
Pantoprazole + Riociguat
Severity: Moderate
Pantoprazole and Riociguat: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Riociguat absorption is reduced when gastric pH is elevated, so acid suppression may lower exposure and the effect on pulmonary hypertension. Pantoprazole is not a strong inhibitor of the CYP enzymes that clear riociguat, so the concern is reduced absorption rather than toxicity.
What this interaction means in plain words
Pantoprazole and Riociguat can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Pantoprazole belongs to Gastrointestinal Tract; Riociguat belongs to Cardiovascular.
Why it happens
Higher gastric pH reduces riociguat solubility and absorption; pantoprazole is not a significant inhibitor of riociguat metabolism.
What to do
Monitor clinical response and blood pressure; riociguat dose may need to be adjusted when acid suppressants are started or stopped.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Pantoprazole
- Pantoprazole + Rilpivirine Contraindicated
- Acalabrutinib + Pantoprazole Major
- Atazanavir + Pantoprazole Major
- Dacomitinib + Pantoprazole Major
- Dasatinib + Pantoprazole Major
- Erlotinib + Pantoprazole Major
Other interactions of Riociguat
- Avanafil + Riociguat Contraindicated
- Dipyridamole + Riociguat Contraindicated
- Isosorbide dinitrate + Riociguat Contraindicated
- Isosorbide mononitrate + Riociguat Contraindicated
- Nitroglycerin + Riociguat Contraindicated
- Riociguat + Sildenafil Contraindicated
Frequently asked questions
Can I take Pantoprazole with Riociguat?
MediHelp rates the interaction as moderate. Pantoprazole and Riociguat can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Riociguat absorption is reduced when gastric pH is elevated, so acid suppression may lower exposure and the effect on pulmonary hypertension. Pantoprazole is not a strong inhibitor of the CYP enzymes that clear riociguat, so the concern is reduced absorption rather than toxicity.
How serious is the interaction between Pantoprazole and Riociguat?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor clinical response and blood pressure; riociguat dose may need to be adjusted when acid suppressants are started or stopped.
What other medicines interact with Pantoprazole?
MediHelp also lists interactions of Pantoprazole with, for example, Rilpivirine, Acalabrutinib, Atazanavir. The full list is on the Pantoprazole page.
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