Lansoprazole, Amoxicillin, and Clarithromycin (Oral)

Overview

Helicobacter pylori, also known as H. pylori, is a microaerophilic, gram-negative bacteria and is usually found in the stomach. It is not uncommon for H. pylori bacteria to be found in the stomach and it's estimated that over 50% of the world's population have some of the bacteria in their body. In the vast majority of cases, patients with H. pylori do not exhibit any symptoms and are unaware that the bacteria is present.

In some cases, however, an acute H. pylori infection can mimic the symptoms of acute gastritis. Patients may experience symptoms, such as nausea or stomach pains. If the condition becomes chronic, patients may also develop bloating and vomiting.

When H. pylori bacteria is present in the stomach, it can cause chronic inflammation. As a result, patients are more at risk of developing gastric or duodenal ulcers. Typically, inflammation in the corpus is more likely to lead to gastric ulcers, whilst inflammation of the pyloric antrum has a higher chance of causing duodenal ulcers. When the protective mucosa is damaged by the bacteria, the lining of the stomach and/or duodenum can be damaged by the gastric acids, enabling ulcers to form.

Prescribed as a combination medicine, Lansoprazole, Amoxicillin, and Clarithromycin can be used to treat H. pylori bacterial infections and/or ulcers caused by the condition. As a proton pump inhibitor, Lansoprazole reduces the amount of acid produced by the stomach and neutralizes the stomach's pH levels. As stomach acid can increase the symptoms of a H. Pylori infection and lead to the formation or exacerbation of ulcers, Lansoprazole helps to relieve the patient's symptoms and prevents their condition from worsening.

Both Amoxicillin and Clarithromycin are antibiotics which are used to eradicate H. pylori bacteria from the patient's body. Clarithromycin is a protein synthesis inhibitor which prevents H. pylori bacteria cells from replicating and spreading further. In doing so, the antibiotic also enables the existing cells to be destroyed. Similarly, Amoxicillin works by adhering to the walls of bacteria cells and destroying them. When used together, Amoxicillin and Clarithromycin can be used to fully resolve the patient's H. pylori infection.

Although Lansoprazole, Amoxicillin, and Clarithromycin is considered to be a first-line treatment for H. pylori infections, gastric ulcers and duodenal ulcers, additional medication can be used if the patient's symptoms persist. However, if patients take Lansoprazole, Amoxicillin, and Clarithromycin for the full course of treatment, it's likely that this combination of medication will successfully eradicate the infection from their body and relieve the associated symptoms.

Conditions Treated

  • H. pylori infection
  • Gastric ulcers
  • Duodenal ulcers

Type Of Medicine

  • Proton pump inhibitor (Lansoprazole)
  • Antibiotic (Amoxicillin and Clarithromycin)

Side Effects

When patient's take medication, it's not unusual for them to experience some side effects. Often, these will be more pronounced when patients first start using a new medication but will be relieved over time. In some cases, patients may develop the following side effects when taking Lansoprazole, Amoxicillin, and Clarithromycin:

  • Confusion
  • Unusual, unpleasant or bad aftertaste
  • Discoloration of the tongue
  • Change in taste
  • Itching of the vagina or genital area
  • White patches in the throat or mouth, or on the tongue
  • Pain during sexual intercourse
  • Thick, white vaginal discharge with a mild odor or no odor
  • Swelling, redness or soreness of the tongue
  • Sore mouth or tongue

If the above side effects are not severe or troublesome, the patient may not need to seek medical attention for them. However, if they are ongoing, serious or bothersome, patients should obtain medical help.

Similarly, patients should contact their physician immediately if they experience the following side effects when taking Lansoprazole, Amoxicillin, and Clarithromycin:

  • Stomach or abdominal tenderness or pain
  • Loosening, peeling or blistering of the skin
  • Clay colored stools
  • Fever or chills
  • Dark urine
  • Slow, irregular or fast heartbeat
  • Diarrhea
  • Headache
  • Difficulty with swallowing
  • Rash on the skin
  • Fainting or dizziness
  • Itching or hives
  • Muscle or joint pain
  • Red skin lesions, sometimes with a purple center
  • Tightness in the chest
  • Loss of appetite
  • Unusual weight gain
  • Irritated, red eyes
  • Severe and watery diarrhea, which may also be bloody
  • Nausea and vomiting
  • Swelling or puffiness around the lips, face, tongue, face or of the eyelids red skin lesions, often with a purple center
  • Yellowing of the skin or eyes
  • Ulcers, white spots or sores on the lips or in the mouth
  • Swelling of the feet, ankles or body
  • Unusual weakness or tiredness

Although the above side effects are not particularly common, they do warrant medical attention. In addition to this, patients should seek medical help if they experience any side effects which are not listed above when taking Lansoprazole, Amoxicillin, and Clarithromycin.

Dosage

When adult patients are prescribed Lansoprazole, Amoxicillin, and Clarithromycin as a combination medicine, they are usually instructed to take 30mg or 1 capsule of Lansoprazole, 1000mg or 2 capsules of Amoxicillin and 500mg or 1 capsule of Clarithromycin, twice per day.

Whilst this is a standard form of treatment with Lansoprazole, Amoxicillin, and Clarithromycin, patients may be given a modified or altered dose of medication and should follow their physician's instructions regarding how much medicine to take and when to take it.

Generally, Lansoprazole, Amoxicillin, and Clarithromycin is supplied in a kit, with the different medications being easily identifiable. For example, Lansoprazole, Amoxicillin, and Clarithromycin is often accompanied by a daily instruction and administration card which helps to ensure that the patient takes the appropriate dose of medicine. Each medication is supplied as a different colored tablet or capsule so patients should be able to identify which medicines to take and when to take them.

When taking Lansoprazole, Amoxicillin, and Clarithromycin capsules and tablets, patients should swallow each tablet or capsule whole and should not attempt to break them, crush them or open them.

Patients are usually advised to take this medicine on an empty stomach, before eating a meal. If possible, patients should attempt to take their medication at approximately the same time each day.

When taking Lansoprazole, Amoxicillin, and Clarithromycin, patients may notice a reduction in their symptoms. However, they should continue taking the medicine for the full course of treatment or until they are told to stop. If patients stop taking Lansoprazole, Amoxicillin, and Clarithromycin too early, the infection is likely to recur and may be more difficult to treat in the future.

If patients forget to take a dose of medication, they should take it as soon as they remember to. However, if their next dose of Lansoprazole, Amoxicillin, and Clarithromycin is almost due, they should skip the dose they've missed completely and continue with their normal treatment schedule. Patients should not attempt to take an extra or double dose of Lansoprazole, Amoxicillin, and Clarithromycin, even if they have missed an earlier dose.

It's important that patients take Lansoprazole, Amoxicillin, and Clarithromycin in accordance with their doctor's instructions. If patients are unsure how or when to take Lansoprazole, Amoxicillin, and Clarithromycin, they should contact their physician or pharmacies for advice.

Potential Drug Interactions

Although some medicines can be taken at the same time, others may interact with each other and should not be used alongside one another. For example, Lansoprazole, Amoxicillin, and Clarithromycin should not be prescribed in conjunction with any of the following medicines:

  • Alfuzosin
  • Lurasidone
  • Amifampridine
  • Maraviroc
  • Amisulpride
  • Ketoconazole
  • Astemizole
  • Ivabradine
  • Bepridil
  • Methysergide
  • Cisapride
  • Nelfinavir
  • Colchicine
  • Naloxegol
  • Conivaptan
  • Methylergonovine
  • Dihydroergotamine
  • Piperaquine
  • Dronedarone
  • Silodosin
  • Eletriptan
  • Sparfloxacin
  • Eliglustat
  • Rilpivirine
  • Eplerenone
  • Terfenadine
  • Ergoloid Mesylates
  • SimvastatinErgonovine
  • Ergotamine
  • Saquinavir
  • Flibanserin
  • Fluconazole
  • Ranolazine
  • Isavuconazonium Sulfate
  • Thioridazine
  • Lomitapide
  • Tolvaptan
  • Lovastatin
  • Pimozide
  • Mesoridazine
  • Venetoclax
  • Nimodipine
  • Ziprasidone
  • Posaconazole

Similarly, the use of Lansoprazole, Amoxicillin, and Clarithromycin in conjunction with any of the medications listed below is not usually advisable:

  • Ado-Trastuzumab Emtansine
  • Flecainide
  • Afatinib
  • Fluticasone
  • Ajmaline
  • Fosaprepitant
  • Alprazolam
  • Fluoxetine
  • Amiodarone
  • Famotidine
  • Amitriptyline
  • Felodipine
  • Amlodipine
  • Felbamate
  • Amobarbital
  • Fingolimod
  • Amprenavir
  • Fentanyl
  • Anagrelide
  • Galantamine
  • Apixaban
  • Granisetron
  • Apomorphine
  • Halofantrine
  • Aprepitant
  • Gonadorelin
  • Aprindine
  • Gemifloxacin
  • Aprobarbital
  • Gatifloxacin
  • Aripiprazole
  • Goserelin
  • Arsenic Trioxide
  • Gefitinib
  • Artemether
  • Lapatinib
  • Asenapine
  • Levomilnacipran
  • Atazanavir
  • Ledipasvir
  • Atorvastatin
  • Leuprolide
  • Avanafil
  • Levofloxacin
  • Axitinib
  • Letrozole
  • Azithromycin
  • Lumacaftor
  • Bedaquiline
  • Macitentan
  • Bosutinib
  • Manidipine
  • Bretylium
  • Meclocycline
  • Brexpiprazole
  • Lymecycline
  • Bromocriptine
  • Lumefantrine
  • Buserelin
  • Mephobarbital
  • Butabarbital
  • Mefloquine
  • Butalbital
  • Metronidazole
  • Cabazitaxel
  • Mizolastine
  • Cabozantinib
  • Mifepristone
  • Calcifediol
  • Methotrexate
  • Carbamazepine
  • Minocycline
  • Cariprazine
  • Modafinil
  • Ceritinib
  • Morphine
  • Chloroquine
  • Midazolam
  • Chlorpromazine
  • Nafarelin
  • Chlortetracycline
  • Nilotinib
  • Cholera Vaccine, Live
  • Nortriptyline
  • Cilostazol
  • Octreotide
  • Ciprofloxacin
  • Ondansetron
  • Citalopram
  • Olaparib
  • Clomipramine
  • Norfloxacin
  • Clonazepam
  • Olanzapine
  • Clozapine
  • Ofloxacin
  • Cobicistat
  • Nifedipine
  • Cobimetinib
  • Nelfinavir
  • Crizotinib
  • Nisoldipine
  • Cyclobenzaprine
  • Nicardipine
  • Dabigatran Etexilate
  • Nafcillin
  • Dabrafenib
  • Ospemifene
  • Daclatasvir
  • Paroxetine
  • Dasatinib
  • Oxytetracycline
  • Degarelix
  • Pasireotide
  • Delamanid
  • Pazopanib
  • Delavirdine
  • Paliperidone
  • Demeclocycline
  • Oxcarbazepine
  • Desipramine
  • Oxycodone
  • Deslorelin
  • Velpatasvir
  • Pentamidine
  • Vincristine Sulfate Liposome
  • Dexamethasone
  • Vilazodone
  • Palbociclib
  • Venlafaxine
  • Digoxin
  • Verapamil
  • Panobinostat
  • Vilanterol
  • Diltiazem
  • Vincristine
  • Phenobarbital
  • Vinblastine
  • Disopyramide
  • Vemurafenib
  • Procainamide
  • Docetaxel
  • Pimavanserin
  • Dofetilide
  • Pitolisant
  • Dolasetron
  • Pirmenol
  • Domperidone
  • Pixantrone
  • Donepezil
  • Pipamperone
  • Doxepin
  • Probucol
  • Doxorubicin
  • Ponatinib
  • Doxorubicin Hydrochloride Liposome
  • Phenytoin
  • Doxycycline
  • Promethazine
  • Droperidol
  • Quinidine
  • Dutasteride
  • Quinine
  • Ebastine
  • Reboxetine
  • Efavirenz
  • Protriptyline
  • Enzalutamide
  • Quetiapine
  • Eribulin
  • Regorafenib
  • Erlotinib
  • Propafenone
  • Erythromycin
  • Sulpiride
  • Escitalopram
  • Sunitinib
  • Eslicarbazepine Acetate
  • Tamoxifen
  • Estazolam
  • Tadalafil
  • Eszopiclone
  • Tamsulosin
  • Etravirine
  • Tacrolimus
  • Everolimus
  • Telaprevir
  • Foscarnet
  • Suvorexant
  • Fosphenytoin
  • Telavancin
  • Haloperidol
  • Risperidone
  • Halothane
  • Romidepsin
  • Histrelin
  • Ruxolitinib
  • Hydrocodone
  • Rolitetracycline
  • Hydroquinidine
  • Rivaroxaban
  • Hydroxychloroquine
  • Roflumilast
  • Hydroxyzine
  • Salmeterol
  • Ibrutinib
  • Secobarbital
  • Vinorelbine
  • Ibutilide
  • Warfarin
  • Saquinavir
  • Vismodegib
  • Idelalisib
  • Zuclopenthixol
  • Sertindole
  • Vinflunine
  • Ifosfamide
  • Vorapaxar
  • Ritonavir
  • Voriconazole
  • Iloperidone
  • Vorinostat
  • Sonidegib
  • Zaleplon
  • Imipramine
  • Zolpidem
  • Sorafenib
  • Irinotecan
  • Sotalol
  • Irinotecan Liposome
  • Solifenacin
  • Isoflurane
  • Spiramycin
  • Isradipine
  • Tramadol
  • Itraconazole
  • Topotecan
  • Ivacaftor
  • Tizanidine
  • Ixabepilone
  • Toremifene
  • Ketoconazole
  • Tolterodine
  • Lopinavir
  • Trabectedin
  • Lorcainide
  • Simeprevir
  • Losartan
  • Sildenafil
  • Methacycline
  • Sevoflurane
  • Methadone
  • Sirolimus
  • Methohexital
  • Sulfamethoxazole
  • Morphine Sulfate Liposome
  • Temsirolimus
  • Moxifloxacin
  • Tetrabenazine
  • Mycophenolate Mofetil
  • Tetracycline
  • Pentobarbital
  • Thiopental
  • Perampanel
  • Telithromycin
  • Perflutren Lipid Microsphere
  • Ticagrelor
  • Perphenazine
  • Triazolam
  • Prochlorperazine
  • Trimipramine
  • Retapamulin
  • Trazodone
  • Rifabutin
  • Triptorelin
  • Rifapentine
  • Trimethoprim
  • Sodium Phosphate
  • Vandetanib
  • Sodium Phosphate, Dibasic
  • Vardenafil
  • Sodium Phosphate, Monobasic
  • Zidovudine
  • St John's Wort
  • Zileuton

Although the use of Lansoprazole, Amoxicillin, and Clarithromycin alongside the above medications is not normally recommended, doctors may decide it's in the patient's best interests in some cases. If so, the patient may be advised to take their medication at a specific time or may be prescribed a modified dose of medicine in order to try and prevent an interaction from occurring.

Patients should also be aware that they have an increased risk of experiencing side effects if Lansoprazole, Amoxicillin, and Clarithromycin is taken in conjunction with any of the following:

  • Acenocoumarol
  • Hexobarbital
  • Alfentanil
  • Indinavir
  • Conjugated Estrogens
  • Glyburide
  • Cyclosporine
  • Glipizide
  • Darunavir
  • Khat
  • Delavirdine
  • Pravastatin
  • Diazepam
  • Phenprocoumon
  • Dicumarol
  • Repaglinide
  • Esterified Estrogens
  • Probenecid
  • Estradiol
  • Rifampin
  • Estriol
  • Nevirapine
  • Estrone
  • Tipranavir
  • Estropipate
  • Prednisone
  • Ethinyl Estradiol
  • Methylprednisolone
  • Levothyroxine
  • Tacrolimus
  • Linezolid
  • Warfarin

Furthermore, Lansoprazole, Amoxicillin, and Clarithromycin may interact with other substances, such as foods, prescription medication, vitamins and/or supplements. If patients take this medication and consume the following, they may experience increased side effects:

  • Cranberries, cranberry juice and other cranberry derivatives

In addition to this, patients could experience increased side effects if they take Lansoprazole, Amoxicillin, and Clarithromycin on a full stomach.

In order to avoid an interaction occurring, patients should tell their physician if they are using any other medicines, vitamins or supplements before they start taking Lansoprazole, Amoxicillin, and Clarithromycin. Once patients have started taking this medicine, they should obtain medical advice before using any new medications, supplements or vitamins.

Warnings

If patients have any other health problems, they should notify their doctor before they begin using Lansoprazole, Amoxicillin, and Clarithromycin. There are some conditions which can affect treatment with this medication and these may include:

  • Severe muscle weakness (Myasthenia gravis)
  • Kidney disease
  • Allergy or previous reaction to Amoxicillin, Penicillin and/or cephalosporins
  • Systemic lupus erythematosus (SLE)
  • Diarrhea
  • Low levels of potassium in the blood (Hypokalemia)
  • Low levels of magnesium in the blood (Hypomagnesemia)
  • Allergy or previous reaction to Clarithromycin, Erythromycin and/or macrolide antibiotics
  • Cholestatic jaundice
  • Liver disease
  • Heart rhythm problems
  • Allergy or previous reaction to Lansoprazole

To date, specific studies on the effects of Lansoprazole, Amoxicillin, and Clarithromycin on pediatric patients have not been carried out. Due to this, Lansoprazole, Amoxicillin, and Clarithromycin is only usually prescribed to adult patients and may not be used to treat children or infants.

Although Lansoprazole, Amoxicillin, and Clarithromycin can be prescribed to elderly patients, geriatric patients are more likely to have age-related heart, kidney or liver problems which may affect their use of this medication. Geriatric patients may be given a lower dose of Lansoprazole, Amoxicillin, and Clarithromycin initially and their dose may be increased after their response to the medication has been monitored.

If the patient's symptoms worsen or do not improve whilst they are taking Lansoprazole, Amoxicillin, and Clarithromycin, they should contact their physician for further advice. Patients will need to have regular consultations with their physician whilst they are taking Lansoprazole, Amoxicillin, and Clarithromycin. In addition to this, blood tests may need to be taken to ensure that the medication is working as intended and that it is not having any unwanted effects.

When taking Lansoprazole, Amoxicillin, and Clarithromycin, patients may be at risk of developing a serious liver problem and should obtain immediate medical help if they experience the following symptoms:

  • Dark urine
  • Pale stools
  • Loss of appetite
  • Tenderness or pain in the upper stomach
  • Yellowing of the eyes or skin
  • Unusual weakness or tiredness
  • Nausea

Patients may experience changes to their heart rhythm when taking this medicine and should obtain medical assistance if they experience any of the following:

  • Faintness or dizziness
  • Pounding, fast or uneven heartbeat

If anyone in the patient's family has suffered from heart rhythm problems, the patient should inform their physician before taking Lansoprazole, Amoxicillin, and Clarithromycin.

Patients could develop acute interstitial nephritis when taking this medication and should obtain urgent medical help if they develop the following symptoms:

  • Swelling of the feet, ankles or body
  • Unusual weight gain
  • Rash on the skin
  • Fever
  • Pain in the joints

Lansoprazole, Amoxicillin, and Clarithromycin can cause patients to experience severe diarrhea and this may continue for two months or longer after patients have finished the course of treatment. However, patients should not take or use any diarrhea remedies without seeking advice from their physician first.

When patients are taking a proton pump inhibitor, such as Lansoprazole, systemic or cutaneous lupus erythematosus may occur or existing symptoms may worsen. Patients should obtain medical assistance if they experience the following symptoms:

  • Skin rash on the arms and/or cheeks, which may worsen in the sun
  • Pain in the joints

Taking Lansoprazole, Amoxicillin, and Clarithromycin can affect the results of any medical tests which are conducted. If patients are treated or seen by any healthcare practitioners, such as doctors or dentists, they must inform them that they are taking this medicine.

Lansoprazole, Amoxicillin, and Clarithromycin should not be prescribed to patients who are pregnant, unless there is no viable alternative available and the benefits of using the medication significantly outweigh the risks. If Lansoprazole, Amoxicillin, and Clarithromycin is taken by pregnant patients, it may cause harm to the unborn fetus.

If patients become pregnant when using this medicine, they should notify their physician immediately.

Patients are usually advised not to breastfeed when taking this medication. In some instances, medicines can be excreted in breast milk and may cause harm to the infant. Due to this, it is not usually advisable to breastfeed whilst taking Lansoprazole, Amoxicillin, and Clarithromycin or whilst the medication remains in the patient's system. Once patients have completed the course of treatment, they should seek medical advice in order to determine when it is appropriate to resume breastfeeding.

If patients are allergic to any substances, they should inform their doctor before they begin taking Lansoprazole, Amoxicillin, and Clarithromycin. In some cases, this combination medicine can cause patients to experience a serious allergic reaction, including anaphylaxis. The symptoms of this reaction may include:

  • Itching
  • Chills
  • Fever
  • Rash on the skin
  • Difficulty breathing
  • Difficulty swallowing
  • Wheezing
  • Hoarseness
  • Ulcers or sores on the skin
  • Swelling of the throat, face, mouth or hands

As a serious allergic reaction can be life-threatening, patients will require emergency medical treatment if they exhibit these symptoms.

Storage

When keeping Lansoprazole, Amoxicillin, and Clarithromycin at home, patients should follow the manufacturer's instructions. In most cases, this medicine can be kept at room temperature but should be stored in a closed container and protected from light, moisture and heat.

Patients should also ensure that their medication is kept in a safe location and that pets and children cannot gain access to it.

If patients are advised to stop taking Lansoprazole, Amoxicillin, and Clarithromycin or if the medication reaches its expiry date, it should be disposed of carefully. Patients should contact their pharmacist or physician's office and use a specialist medicine disposal service.

Summary

Although H. pylori bacteria is present in most individuals, it does not usually cause any symptoms. However, in some instances, patients may experience nausea and/or stomach pains as a result of a H. pylori infection. In addition to this, patients could develop gastric or duodenal ulcers as a result of the infection or may be more at risk of developing these ulcers, if they haven't already.

By using Lansoprazole, Amoxicillin, and Clarithromycin, physicians can ensure that the infection is eradicated from the patient's body. In doing so, the patient's symptoms should decrease and the risk of the patient developing further complications as a result of the infection should be reduced.