Amoxicillin Clarithromycin Omeprazole

Amoxicillin Clarithromycin Omeprazole Brand Name– Omeclamox

What is Amoxicillin Clarithromycin Omeprazole

Amoxicillin capsules, clarithromycin immediate-release tablets, and omeprazole delayed-release capsules are packaged together in a product known as Omeclamox-Pak, used for the eradication of Helicobacter pylori (H. pylori) in patients with duodenal ulcer.

Amoxicillin is an aminopenicillin, clarithromycin is a macrolide antibiotic, and omeprazole is a proton-pump inhibitor (PPI).

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 (less than 10%), starting a 2 to 4 week empiric trial of a proton pump inhibitor (PPI) is an alternate approach.

Some data suggest that active H. pylori infection may play a role in decreasing iron absorption from the gut and may be a contributing cause of iron deficiency anemia and idiopathic thrombocytopenic 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.

Triple-drug regimens are recommended by the American College of Gastroenterology (ACG) guidelines for managing H. pylori infection; triple-drug regimens containing amoxicillin, clarithromycin, and a PPI are associated with a high eradication rate and fewer side effects than triple-drug regimens which include metronidazole.

Indications

  • Helicobacter pylori
  • Helicobacter pylori (H. pylori) eradication

Side Effects

  1. abdominal pain
  2. abnormal dreams
  3. acute generalized exanthematous pustulosis (AGEP)
  4. agitation
  5. agranulocytosis
  6. alopecia
  7. anaphylactic shock
  8. anaphylactoid reactions
  9. anemia
  10. angina
  11. angioedema
  12. anorexia
  13. anxiety
  14. arthralgia
  15. aseptic meningitis
  16. asthenia
  17. azotemia
  18. back pain
  19. blurred vision
  20. bradycardia
  21. bronchospasm
  22. candidiasis
  23. chest pain (unspecified)
  24. cholestasis
  25. confusion
  26. constipation
  27. cough
  28. crystalluria
  29. depression
  30. diarrhea
  31. dizziness
  32. drowsiness
  33. dysgeusia
  34. dyspepsia
  35. elevated hepatic enzymes
  36. epistaxis
  37. erythema multiforme
  38. exfoliative dermatitis
  39. fatigue
  40. fever
  41. flatulence
  42. gastritis
  43. glycosuria
  44. gynecomastia
  45. hallucinations
  46. headache
  47. hearing loss
  48. hematuria
  49. hemolytic anemia
  50. hepatic encephalopathy
  51. hepatic failure
  52. hepatic necrosis
  53. hepatitis
  54. hyperbilirubinemia
  55. hyperhidrosis
  56. hypoglycemia
  57. hyponatremia
  58. increased urinary frequency
  59. infection
  60. insomnia
  61. interstitial nephritis
  62. jaundice
  63. leukocytosis
  64. leukopenia
  65. lupus-like symptoms
  66. maculopapular rash
  67. malaise
  68. mania
  69. muscle cramps
  70. myalgia
  71. myasthenia
  72. nausea
  73. neutropenia
  74. nightmares
  75. ocular irritation
  76. optic atrophy
  77. optic neuritis
  78. palpitations
  79. pancreatitis
  80. pancytopenia
  81. paresthesias
  82. peripheral edema
  83. pernicious anemia
  84. petechiae
  85. photosensitivity
  86. proteinuria
  87. pruritus
  88. pseudomembranous colitis
  89. psychosis
  90. purpura
  91. pyuria
  92. QT prolongation
  93. rash
  94. seizures
  95. serum sickness
  96. sinus tachycardia
  97. Stevens-Johnson syndrome
  98. stomatitis
  99. stool discoloration
  100. superinfection
  101. testicular pain
  102. thrombocytopenia
  103. thrombotic thrombocytopenic purpura (TTP)
  104. tinnitus
  105. tongue discoloration
  106. tooth discoloration
  107. torsade de pointes
  108. toxic epidermal necrolysis
  109. tremor
  110. urticaria
  111. ventricular tachycardia
  112. vertigo
  113. vitamin B12 deficiency
  114. vomiting
  115. weakness
  116. weight gain
  117. xerophthalmia
  118. xerosis
  119. xerostomia

Monitoring Parameters

  • LFTs
  • serum calcium
  • serum creatinine/BUN
  • serum magnesium
  • serum potassium

Contraindications

  • alcoholism
  • Asian patients
  • asthma
  • 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
  • hypertension
  • hypocalcemia
  • hypokalemia
  • hypomagnesemia
  • infants
  • inflammatory bowel disease
  • laboratory test interference
  • leukemia
  • long QT syndrome
  • macrolide hypersensitivity
  • malnutrition
  • mononucleosis
  • mortality
  • myasthenia gravis
  • myocardial infarction
  • neonates
  • osteoporosis
  • penicillin hypersensitivity
  • pregnancy
  • proton pump inhibitors (PPIs) hypersensitivity
  • pseudomembranous colitis
  • QT prolongation
  • renal failure
  • renal impairment
  • reproductive risk
  • systemic lupus erythematosus (SLE)
  • thyroid disease
  • torsade de pointes
  • ulcerative colitis
  • urticaria
  • ventricular arrhythmias
  • viral infection

Interactions

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  • 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
  • Riluzole
  • 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
  • Tirofiban
  • Tocilizumab
  • 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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