Amoxicillin Clarithromycin Lansoprazole

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

  1. abdominal pain
  2. acne vulgaris
  3. acute generalized exanthematous pustulosis (AGEP)
  4. agitation
  5. agranulocytosis
  6. alopecia
  7. amblyopia
  8. amnesia
  9. anaphylactic shock
  10. anaphylactoid reactions
  11. anemia
  12. angina
  13. angioedema
  14. anorexia
  15. anosmia
  16. anxiety
  17. aplastic anemia
  18. appetite stimulation
  19. arthralgia
  20. asthenia
  21. atrial fibrillation
  22. back pain
  23. bezoar
  24. bleeding
  25. blepharitis
  26. blurred vision
  27. bone fractures
  28. bradycardia
  29. breast enlargement
  30. bullous rash
  31. candidiasis
  32. cardiac arrest
  33. cataracts
  34. chest pain (unspecified)
  35. chills
  36. cholelithiasis
  37. cholestasis
  38. colitis
  39. confusion
  40. conjunctivitis
  41. constipation
  42. contact dermatitis
  43. cough
  44. crystalluria
  45. dehydration
  46. depression
  47. diabetes mellitus
  48. diarrhea
  49. diplopia
  50. dizziness
  51. drowsiness
  52. Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)
  53. dysgeusia
  54. dyskinesia
  55. dysmenorrhea
  56. dyspepsia
  57. dysphagia
  58. dyspnea
  59. dysuria
  60. edema
  61. elevated hepatic enzymes
  62. emotional lability
  63. eosinophilia
  64. epistaxis
  65. eructation
  66. erythema multiforme
  67. esophageal ulceration
  68. esophagitis
  69. exfoliative dermatitis
  70. fatigue
  71. fever
  72. flatulence
  73. gastric polyps
  74. gastritis
  75. gastroesophageal reflux
  76. GI bleeding
  77. glossitis
  78. glycosuria
  79. goiter
  80. gout
  81. gynecomastia
  82. halitosis
  83. hallucinations
  84. headache
  85. hearing loss
  86. hematemesis
  87. hematuria
  88. hemolysis
  89. hemolytic anemia
  90. hemoptysis
  91. hepatic failure
  92. hepatitis
  93. hiccups
  94. hostility
  95. hyperactivity
  96. hyperbilirubinemia
  97. hypercholesterolemia
  98. hyperesthesia
  99. hyperglycemia
  100. hyperhidrosis
  101. hyperkalemia
  102. hyperkinesis
  103. hypersalivation
  104. hypertension
  105. hypertonia
  106. hypoglycemia
  107. hypomagnesemia
  108. hypotension
  109. hypothyroidism
  110. impotence (erectile dysfunction)
  111. increased urinary frequency
  112. infection
  113. insomnia
  114. interstitial nephritis
  115. jaundice
  116. leukopenia
  117. leukorrhea
  118. libido decrease
  119. libido increase
  120. lupus-like symptoms
  121. lymphadenopathy
  122. maculopapular rash
  123. malaise
  124. mania
  125. melena
  126. menorrhagia
  127. migraine
  128. muscle cramps
  129. musculoskeletal pain
  130. myalgia
  131. myasthenia
  132. myocardial infarction
  133. myopathy
  134. nausea
  135. nephrotic syndrome
  136. neutropenia
  137. ocular pain
  138. oral ulceration
  139. palpitations
  140. pancreatitis
  141. pancytopenia
  142. paresthesias
  143. parosmia
  144. pelvic pain
  145. peripheral edema
  146. peripheral vasodilation
  147. pernicious anemia
  148. pharyngitis
  149. photophobia
  150. polyuria
  151. pruritus
  152. pseudomembranous colitis
  153. psychosis
  154. ptosis
  155. pulmonary embolism
  156. purpura
  157. QT prolongation
  158. rash
  159. renal failure (unspecified)
  160. renal tubular necrosis
  161. rhinitis
  162. seizures
  163. serum sickness
  164. sinus tachycardia
  165. sinusitis
  166. Stevens-Johnson syndrome
  167. stomatitis
  168. stroke
  169. superinfection
  170. syncope
  171. synovitis
  172. tenesmus
  173. thrombocytopenia
  174. thrombotic thrombocytopenic purpura (TTP)
  175. tinnitus
  176. tongue discoloration
  177. tooth discoloration
  178. torsade de pointes
  179. toxic epidermal necrolysis
  180. tremor
  181. urethral pain
  182. urinary retention
  183. urinary urgency
  184. urticaria
  185. vaginitis
  186. vasculitis
  187. ventricular tachycardia
  188. vertigo
  189. visual impairment
  190. vitamin B12 deficiency
  191. vomiting
  192. weight gain
  193. weight loss
  194. xerophthalmia
  195. xerosis
  196. 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

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  • grapefruit juice
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  • Midostaurin
  • Mifepristone
  • Miglitol
  • Mirtazapine
  • Mitotane
  • Modafinil
  • Mometasone
  • Moxifloxacin
  • Mycophenolate
  • Naldemedine
  • Naloxegol
  • Nanoparticle Albumin-Bound Paclitaxel
  • Nateglinide
  • Nelfinavir
  • Neratinib
  • Netupitant, Fosnetupitant; Palonosetron
  • Nevirapine
  • Niacin; Simvastatin
  • Nicardipine
  • Nifedipine
  • Nilotinib
  • Nimodipine
  • Nintedanib
  • Nisoldipine
  • Norethindrone
  • Norfloxacin
  • Norgestrel
  • Nortriptyline
  • Octreotide
  • Ofloxacin
  • Olanzapine
  • Olaparib
  • Ombitasvir; Paritaprevir; Ritonavir
  • Omeprazole; Amoxicillin; Rifabutin
  • Ondansetron
  • Oral Contraceptives
  • Oritavancin
  • Osilodrostat
  • Osimertinib
  • Ospemifene
  • Oxaliplatin
  • Oxcarbazepine
  • Oxybutynin
  • Oxycodone
  • Ozanimod
  • Paclitaxel
  • Palbociclib
  • Paliperidone
  • Panobinostat
  • Paricalcitol
  • Pasireotide
  • Pazopanib
  • Pemigatinib
  • Pentamidine
  • Pentobarbital
  • Perampanel
  • Perindopril; Amlodipine
  • Perphenazine
  • Perphenazine; Amitriptyline
  • Pexidartinib
  • Phenobarbital
  • Phenylephrine; Promethazine
  • Phenytoin
  • Pimavanserin
  • Pimozide
  • Pioglitazone
  • Pitolisant
  • Polatuzumab Vedotin
  • Polyethylene Glycol; Electrolytes; Bisacodyl
  • Ponatinib
  • Posaconazole
  • Pramlintide
  • Pravastatin
  • Primaquine
  • Primidone
  • Probenecid
  • Procainamide
  • Prochlorperazine
  • Progesterone
  • Promethazine
  • Propafenone
  • Propantheline
  • Protriptyline
  • Pyrimethamine; Sulfadoxine
  • Quazepam
  • Quetiapine
  • Quinidine
  • Quinine
  • Ramelteon
  • Ranolazine
  • Red Yeast Rice
  • Regorafenib
  • Repaglinide
  • Retapamulin
  • Revefenacin
  • Ribociclib
  • Ribociclib; Letrozole
  • Rifabutin
  • Rifampin
  • Rifapentine
  • Rifaximin
  • Rilpivirine
  • Rimegepant
  • Ripretinib
  • Risedronate
  • Risperidone
  • Ritonavir
  • Rivaroxaban
  • Romidepsin
  • Rosiglitazone
  • Rosuvastatin
  • Ruxolitinib
  • Salsalate
  • Saquinavir
  • Saxagliptin
  • Scopolamine
  • Secobarbital
  • Secretin
  • Segesterone Acetate; Ethinyl Estradiol
  • Selpercatinib
  • Selumetinib
  • Semaglutide
  • Sertraline
  • Sevoflurane
  • SGLT2 Inhibitors
  • Short-acting beta-agonists
  • Sibutramine
  • Sildenafil
  • Silodosin
  • Simeprevir
  • Simvastatin
  • Simvastatin; Sitagliptin
  • 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
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