Amoxicillin Clarithromycin Lansoprazole Brand Name– Prevpac
What is Amoxicillin Clarithromycin Lansoprazole
Amoxicillin capsules, clarithromycin immediate-release tablets, and lansoprazole delayed-release capsules are packaged together in a product known as Prevpac(R), used for the eradication of Helicobacter pylori (H. pylori) in patients with duodenal ulcer.
Clinicians should test for H. pylori infection in patients presenting with non-ulcer dyspepsia; patients found to be H. pylori positive should be started on combination eradication therapy.
Eradication of H. pylori offers modest, but significant, symptom relief in non-ulcer dyspepsia and reduces the risk of developing peptic ulcer disease, atrophic gastritis, and gastric cancer.
For populations with a low prevalence of H. pylori infection (< 10%), starting a 2—4 week empiric trial of a proton pump inhibitor (PPI) is an alternate approach.
Some evidence suggests that active H. pylori infection may also play a role in decreasing iron absorption from the gut and may be a contributing cause of iron deficiency anemia and idiopathic thrombocytopenia purpura (ITP).
Eradication of the infection may improve oral iron absorption in patients with asymptomatic gastritis; H. pylori infection should be investigated and treated in patients with unexplained iron deficiency.
Amoxicillin, a semisynthetic aminopenicillin, and clarithromycin, a macrolide, both have activity against H. pylori. Lansoprazole, a PPI, suppresses gastric acid.
When given for 2 weeks, the regimen included in the Prevpac(R) administration kit is one of several triple-drug regimens recommended by the American College of Gastroenterology (ACG) guidelines for managing H. pylori infection; this regimen is associated with a high eradication rate and fewer side effects than triple-drug regimens which include metronidazole.
Prevpac(R) was approved by the FDA in December 1997.
Indications
- Helicobacter pylori
- Helicobacter pylori (H. pylori) eradication
Side Effects
- abdominal pain
- acne vulgaris
- acute generalized exanthematous pustulosis (AGEP)
- agitation
- agranulocytosis
- alopecia
- amblyopia
- amnesia
- anaphylactic shock
- anaphylactoid reactions
- anemia
- angina
- angioedema
- anorexia
- anosmia
- anxiety
- aplastic anemia
- appetite stimulation
- arthralgia
- asthenia
- atrial fibrillation
- back pain
- bezoar
- bleeding
- blepharitis
- blurred vision
- bone fractures
- bradycardia
- breast enlargement
- bullous rash
- candidiasis
- cardiac arrest
- cataracts
- chest pain (unspecified)
- chills
- cholelithiasis
- cholestasis
- colitis
- confusion
- conjunctivitis
- constipation
- contact dermatitis
- cough
- crystalluria
- dehydration
- depression
- diabetes mellitus
- diarrhea
- diplopia
- dizziness
- drowsiness
- Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)
- dysgeusia
- dyskinesia
- dysmenorrhea
- dyspepsia
- dysphagia
- dyspnea
- dysuria
- edema
- elevated hepatic enzymes
- emotional lability
- eosinophilia
- epistaxis
- eructation
- erythema multiforme
- esophageal ulceration
- esophagitis
- exfoliative dermatitis
- fatigue
- fever
- flatulence
- gastric polyps
- gastritis
- gastroesophageal reflux
- GI bleeding
- glossitis
- glycosuria
- goiter
- gout
- gynecomastia
- halitosis
- hallucinations
- headache
- hearing loss
- hematemesis
- hematuria
- hemolysis
- hemolytic anemia
- hemoptysis
- hepatic failure
- hepatitis
- hiccups
- hostility
- hyperactivity
- hyperbilirubinemia
- hypercholesterolemia
- hyperesthesia
- hyperglycemia
- hyperhidrosis
- hyperkalemia
- hyperkinesis
- hypersalivation
- hypertension
- hypertonia
- hypoglycemia
- hypomagnesemia
- hypotension
- hypothyroidism
- impotence (erectile dysfunction)
- increased urinary frequency
- infection
- insomnia
- interstitial nephritis
- jaundice
- leukopenia
- leukorrhea
- libido decrease
- libido increase
- lupus-like symptoms
- lymphadenopathy
- maculopapular rash
- malaise
- mania
- melena
- menorrhagia
- migraine
- muscle cramps
- musculoskeletal pain
- myalgia
- myasthenia
- myocardial infarction
- myopathy
- nausea
- nephrotic syndrome
- neutropenia
- ocular pain
- oral ulceration
- palpitations
- pancreatitis
- pancytopenia
- paresthesias
- parosmia
- pelvic pain
- peripheral edema
- peripheral vasodilation
- pernicious anemia
- pharyngitis
- photophobia
- polyuria
- pruritus
- pseudomembranous colitis
- psychosis
- ptosis
- pulmonary embolism
- purpura
- QT prolongation
- rash
- renal failure (unspecified)
- renal tubular necrosis
- rhinitis
- seizures
- serum sickness
- sinus tachycardia
- sinusitis
- Stevens-Johnson syndrome
- stomatitis
- stroke
- superinfection
- syncope
- synovitis
- tenesmus
- thrombocytopenia
- thrombotic thrombocytopenic purpura (TTP)
- tinnitus
- tongue discoloration
- tooth discoloration
- torsade de pointes
- toxic epidermal necrolysis
- tremor
- urethral pain
- urinary retention
- urinary urgency
- urticaria
- vaginitis
- vasculitis
- ventricular tachycardia
- vertigo
- visual impairment
- vitamin B12 deficiency
- vomiting
- weight gain
- weight loss
- xerophthalmia
- xerosis
- xerostomia
Monitoring Parameters
- LFTs
- serum calcium
- serum creatinine/BUN
- serum magnesium
- serum potassium
Contraindications
- alcoholism
- asthma
- bone fractures
- bradycardia
- breast-feeding
- carbapenem hypersensitivity
- cardiac arrhythmias
- cardiac disease
- cephalosporin hypersensitivity
- children
- colitis
- coronary artery disease
- diabetes mellitus
- diarrhea
- eczema
- females
- gastric cancer
- geriatric
- GI bleeding
- GI disease
- heart failure
- hepatic disease
- hepatitis
- hypertension
- hypocalcemia
- hypokalemia
- hypomagnesemia
- infants
- inflammatory bowel disease
- jaundice
- laboratory test interference
- leukemia
- long QT syndrome
- macrolide hypersensitivity
- malnutrition
- mononucleosis
- mortality
- myasthenia gravis
- myocardial infarction
- osteoporosis
- penicillin hypersensitivity
- pregnancy
- proton pump inhibitors (PPIs) hypersensitivity
- pseudomembranous colitis
- QT prolongation
- renal failure
- renal impairment
- systemic lupus erythematosus (SLE)
- thyroid disease
- torsade de pointes
- ulcerative colitis
- urticaria
- ventricular arrhythmias
- viral infection
Interactions
- Abacavir; Lamivudine, 3TC; Zidovudine, ZDV
- Abarelix
- Abemaciclib
- Acalabrutinib
- Acarbose
- Acetaminophen; Aspirin, ASA; Caffeine
- Acetaminophen; Butalbital
- Acetaminophen; Butalbital; Caffeine
- Acetaminophen; Butalbital; Caffeine; Codeine
- Acetaminophen; Caffeine; Dihydrocodeine
- Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
- Acetaminophen; Codeine
- Acetaminophen; Hydrocodone
- Acetaminophen; Oxycodone
- Acetohexamide
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- Allopurinol
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- Ceftibuten
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- Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Hydrocodone
- Chlorpheniramine; Hydrocodone; Phenylephrine
- Chlorpheniramine; Hydrocodone; Pseudoephedrine
- Chlorpromazine
- Chlorpropamide
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- Chlorthalidone; Clonidine
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- food
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- grapefruit juice
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- Siponimod
- Sirolimus
- Sitagliptin
- Sodium Benzoate; Sodium Phenylacetate
- Sodium picosulfate; Magnesium oxide; Anhydrous citric acid
- Sofosbuvir; Velpatasvir
- Sofosbuvir; Velpatasvir; Voxilaprevir
- Solifenacin
- Sonidegib
- Sorafenib
- Sotalol
- Sparfloxacin
- St. John’s Wort, Hypericum perforatum
- Sucralfate
- Sufentanil
- Sulfadiazine
- Sulfamethoxazole; Trimethoprim, SMX-TMP, Cotrimoxazole
- Sulfasalazine
- Sulfisoxazole
- Sulfonamides
- Sulfonylureas
- Sunitinib
- Suvorexant
- Tacrolimus
- Tadalafil
- Talazoparib
- Tamoxifen
- Tamsulosin
- Tasimelteon
- Tazemetostat
- Telaprevir
- Telavancin
- Telithromycin
- Telotristat Ethyl
- Temsirolimus
- Tenofovir Alafenamide
- Tenofovir, PMPA
- Terbinafine
- Tetrabenazine
- Tetracyclines
- Tezacaftor; Ivacaftor
- Theophylline, Aminophylline
- Thiazide diuretics
- Thiazolidinediones
- Thiopental
- Thioridazine
- Thiotepa
- Thyroid hormones
- Ticagrelor
- Tipranavir
- Tofacitinib
- Tolazamide
- Tolbutamide
- Tolterodine
- Tolvaptan
- Topotecan
- Toremifene
- Torsemide
- Trabectedin
- Trandolapril; Verapamil
- Trazodone
- Triamcinolone
- Triazolam
- Tricyclic antidepressants
- Trifluoperazine
- Trihexyphenidyl
- Trimipramine
- Triptorelin
- Trospium
- Tucatinib
- Typhoid Vaccine
- Ubrogepant
- Ulipristal
- Upadacitinib
- Valbenazine
- Valproic Acid, Divalproex Sodium
- Vandetanib
- Vardenafil
- Vemurafenib
- Venetoclax
- Venlafaxine
- Verapamil
- Vilazodone
- Vinblastine
- Vincristine
- Vincristine Liposomal
- Vinorelbine
- Vorapaxar
- Voriconazole
- Vorinostat
- Voxelotor
- Warfarin
- Zafirlukast
- Zaleplon
- Zanubrutinib
- Zidovudine, ZDV
- Zileuton
- Ziprasidone
- Zolpidem
- Zonisamide
