Amoxicillin, clarithromycin, and lansoprazole

You should not take this medicine if you have a history of long QT syndrome or certain heart rhythm disorders, or a history of liver problems caused by taking clarithromycin.

You also should not take this medicine if you have ever had a severe allergic reaction to certain antibiotics, including azithromycin (Zithromax, Z-Pak), erythromycin, telithromycin, amoxicillin or other penicillins (ampicillin, Amoxil, Augmentin, Trimox, and others), or cephalosporins (Duricef, Keflex, Spectracef, and others).

Serious drug interactions can occur when certain medicines are used together. Tell each of your healthcare providers about all medicines you use now, and any medicine you start or stop using.

You should not take this medicine if you are allergic to amoxicillin (Amoxil), clarithromycin (Biaxin), or lansoprazole (Prevacid), or if:

• you have a history of long QT syndrome or certain heart rhythm disorders;

• you have ever had liver problems or jaundice caused by taking clarithromycin;

• you are allergic to azithromycin (Zithromax, Z-Pak), erythromycin, or telithromycin;

• you have had a severe allergic reaction to a penicillin antibiotic, including ampicillin, Augmentin, Principen, Timentin, Trimox, and others; or

• you have had a severe allergic reaction to a cephalosporin antibiotic such as cefdinir, cefprozil, cefuroxime, cephalexin, Duricef, Omnicef, Cefzil, Keflex, Spectracef, and others.

Some medicines can cause unwanted or dangerous effects when used with amoxicillin, clarithromycin, and lansoprazole. Your doctor may need to change your treatment plan if you use any of the following drugs:

• cisapride;

• colchicine (if you also have liver or kidney disease);

• pimozide;

• lovastatin (Advicor, Altoprev, Mevacor) or simvastatin (Zocor, Simcor, Vytorin, Juvisync); or

• ergot medicine--dihydroergotamine, ergotamine, ergonovine, methylergonovine.

To make sure amoxicillin, clarithromycin, and lansoprazole is safe for you, tell your doctor if you have:

• liver disease;

• kidney disease;

• allergies;

• myasthenia gravis;

• osteoporosis or low bone mineral density (osteopenia); or

• an electrolyte imbalance or metabolic disorder.

Taking a proton pump inhibitor such as lansoprazole may increase your risk of bone fracture in the hip, wrist, or spine. This effect has occurred mostly in people who have taken the medication long term or at high doses, and in those who are age 50 and older. It is not clear whether lansoprazole is the actual cause of an increased risk of fracture.

It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

Amoxicillin can make birth control pills less effective. Ask your doctor about using non hormonal birth control (condom, diaphragm with spermicide) to prevent pregnancy while taking amoxicillin, clarithromycin, and lansoprazole.

Amoxicillin and lansoprazole can pass into breast milk and may harm a nursing baby. You should not breast-feed while using this medicine.

This medicine is not approved for use by anyone younger than 18 years old.

Usual Adult Dose for Helicobacter pylori Infection:

Amoxicillin 1000 mg-clarithromycin 500 mg-lansoprazole 30 mg orally 2 times a day
-Duration of therapy: 10 to 14 days

Comment: This drug should be taken in the morning and evening.

Use: Treatment of patients with Helicobacter pylori infection and duodenal ulcer disease to eradicate H pylori

A gout medicine called colchicine (Colcrys) can interact with clarithromycin and cause serious or life-threatening medical problems. You should not take colchicine during your treatment with amoxicillin, clarithromycin, and lansoprazole, especially if you are an older adult with kidney disease.

Many other drugs can interact with clarithromycin. Not all possible interactions are listed here. Tell your doctor about all your medications and any you start or stop using during treatment with amoxicillin, clarithromycin, and lansoprazole, especially:

• atorvastatin (Lipitor, Caduet) or pravastatin (Pravachol);

• carbamazepine;

• insulin or oral diabetes medicine (especially nateglinide, pioglitazone, repaglinide, or rosiglitazone);

• mycophenolate mofetil;

• warfarin (Coumadin, Jantoven);

• HIV or AIDS medicine--atazanavir, ritonavir, saquinavir;

• a Valium-type sedative--alprazolam, midazolam, triazolam;

• heart or blood pressure medication--amlodipine, diltiazem, verapamil;

• heart rhythm medication--amiodarone, disopyramide, dofetilide, dronedarone, ibutilide, procainamide, quinidine, sotalol; or

• sildenafil (Viagra) and other erectile dysfunction medicines--avanafil (Stendra), tadalafil (Cialis), vardenafil (Levitra).

This list is not complete and many other drugs can interact with amoxicillin, clarithromycin, and lansoprazole. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Give a list of all your medicines to any healthcare provider who treats you.

Data not available

A decision should be made to discontinue breastfeeding or discontinue the drug, taking into account the importance of the drug to the mother. Excreted into human milk: Yes (amoxicillin, clarithromycin); Unknown (lansoprazole) Excreted into animal milk: Yes (lansoprazole) Comments: -The American Academy of Pediatrics considers amoxicillin compatible with breastfeeding. -Exposed infants should be monitored for sensitization (e.g., rash), diarrhea, appetite loss, and/or somnolence.

Animal models receiving lansoprazole in breastmilk have revealed evidence of tumorigenicity in carcinogenicity studies; there is a potential risk of serious adverse reactions to the nursing infant.