Omeprazole, Clarithromycin, and Amoxicillin (Oral)

Omeprazole/ clarithromycin/ amoxicillin is a combination drug, in pill form, given to patients suffering from infection-caused gastric ulcers.

Overview

Patients suffering from gastrointestinal ulcers caused by infections may be treated with the medication omeprazole/clarithromycin/amoxicillin. Specifically, it is designed to treat infections caused by the H. pylori bacteria. These three drugs in combination work to reduce acid in the stomach (omeprazole) while simultaneously preventing the growth of bacteria that cause the infection (amoxicillin and clarithromycin). Use of this medication can also help prevent the return of these gastric ulcers by keeping the bacteria from continuing to grow. If ulcers are left untreated, it can result in damage to the stomach or intestinal lining, which leads to tearing or bleeding of the lining, and causes blockages.

Omeprazole/clarithromycin/amoxicillin is available only by prescription. It comes in a capsule or tablet form, and may be provided in a time-release form. There are many other medications which may interact with this drug, and patients should provide a full medical history, including a list of all medications and supplements they are taking. The doctor may determine whether a modified dose is needed, whether the patient should stop taking certain medications, or whether other precautions may be required.

Some of the most common side effects include a headache, having a bad taste in the mouth, or experiencing other changes in taste. There are also some more serious potential side effects which require the immediate attention of a doctor.

Conditions Treated

  • Gastrointestinal ulcers

Type Of Medicine

  • Proton pump inhibitor (PPI)

Side Effects

Not every patient will experience side effects, but in case that side effects do appear, it's important to consult with a physician right away. Some of the more common side effects for omeprazole/clarithromycin/amoxicillin are those associated with taking antibiotics, as well as side effects of taking omeprazole. These include having a bad taste in the mouth or having an unpleasant or usual aftertaste after taking the medication. Changes in taste are also reported by some patients. Other common side effects include experiencing headaches and feelings of nausea.

In addition to the more common side effects, there are a variety of reported side effects, however, the frequency of these is not clear from existing reporting. If patients experience any of the side effects listed below, it is recommended that they contact their doctor immediately to determine what action to take:

  • Tenderness in the abdomen or stomach, or any pain or cramping
  • Peeling or blistering skin, or loose skin
  • Diarrhea which may be severe or very watery, or be bloody
  • Trouble swallowing
  • Feeling dizzy
  • Faster than usual heartbeat
  • Chills or fever
  • Any type of itching, hives, rash or welts appearing on the skin
  • Muscle or joint pain or weakness
  • Swollen or puffy skin around the eyes or eyelid, face, tongue or lips
  • Skin lesions that are red in color, maybe purple in the center
  • Skin redness
  • Any ulcers, sores, or whitish spots around or in the mouth or lips
  • Swollen feet, ankles or other areas of the body
  • A feeling of chest tightness
  • More tired or weak than usual
  • Unusual gaining of weight

Some side effects may be serious symptoms of allergic reaction to omeprazole/ clarithromycin/ amoxicillin. Symptoms such as sudden trouble breathing, speaking or hoarseness, swollen lips, mouth or throat, or an itch or redness may require emergency attention.

Dosage

The right dose of omeprazole/ clarithromycin/ amoxicillin will depend on the individual patient's condition and the strength of the medication. A doctor will prescribe the dose, frequency and amount of time the patient needs to take this medication. omeprazole/ clarithromycin/ amoxicillin is provided in a kit that includes tablets or capsules of each of the drugs omeprazole, clarithromycin and amoxicillin. For adult patients, a single dose consists of one capsule (20 milligrams) of omeprazole, plus two capsules of amoxicillin (1000 mg), plus one single tablet of clarithromycin (500 mg). This combination is taken as one dose and is taken twice per day, for a period of up to ten days.

In children, a doctor should determine the correct dose.

It is important that patients take omeprazole/ clarithromycin/ amoxicillin as prescribed, and do not miss a dose, or take more of any of the three medications, or less than any of the medications, than prescribed. Changes other than those authorized by the doctor can impact the effectiveness of the treatment, as well as result in unwanted side effects.

The omeprazole/ clarithromycin/ amoxicillin kit will include a daily instruction card, so that patients can easily determine the correct number of each capsule or table should be taken at each time a dose is prescribed. The different medications come in different colors to make it easier to distinguish which is the correct capsule or pill to take.

When taking the medication, patients should swallow the tablets and the capsules whole, without chewing. Patients should not try to break or open the capsules or crush the tablets for any reason. A dose should be taken before breakfast and again before dinner, on an empty stomach.

Patients should take the entire sequence of the capsules and tablets as prescribed by the doctor, even if the patient is feeling better once the first few days of medication have been taken. Since an antibiotic is part of this drug combination, completing the entire course of drugs is important. Changing or stopping the medication without the approval of the doctor may cause the condition to return, worsen or fail to heal.

For missed doses, patients should take a missed dose as soon as they remember, however, if it is near the time for the next dose, the missed dose should be skipped, and the normal dose taken. Patients should not double their dose to catch up on a missed on.

Major Drug Interactions

Interactions between different drugs may be a concern, as they can impact the effectiveness of medications for your health or cause unwanted side effects. The drugs identified here are not intended to be all-inclusive, so it is important for patients to provide to their doctor a complete list of any drugs they may be taking, which should include any nonprescription drugs as well as supplements and herbal remedies. For any of the drugs listed, patients should avoid stopping or starting any medications they are taking without consulting their doctor.

There are certain drugs which can interact with omeprazole/ clarithromycin/ amoxicillin, including clopidogrel, clindamycin, ergot alkaloid drugs (ergotamine and dihydroergotamine), digoxin, rifamycins (including rifampin and rifabutin), methotrexate (particularly a high-dose course of treatment), and St John's wort.

Clarithromycin may have an effect on a patient's heart rhythm, known as QT prolongation. There are many other drugs which have the same effect, such as cisapride, amiodarone, disopyramide, dronedarone, dofetilide, pimozide, ibutilide, propafenone, procainamide, sotalol, quinidine, and others.

Clarithromycin may also cause other medications to be removed from the body more slowly, which can thus affect how well those medications might work. Some of these drugs include colchicine, alfuzosin, eplerenone, eletriptan, ranolazine, lurasidone, tamsulosin, silodosin, some statins (for example atorvastatin, simvastatin¸ lovastatin), and ticagrelor, along with others.

The drug omeprazole reduces stomach acid, so some medications which require stomach acid to work might not be properly absorbed into the body when the patient is taking omeprazole. These include erlotinib, atazanavir, rilpivirine, nelfinavir, pazopanib, some azole antifungal medications (ketoconazole, itraconazole, posaconazole), among some others.

Some patients who are using hormonal-type birth control products may need to discuss with their doctor or pharmacist whether taking antibiotics could affect the likelihood of pregnancy. Some of these products include hormonal patches, pills or ring. This interaction might result in pregnancy.

The drug omeprazole is comparable to the medication esomeprazole. Patients who are taking omeprazole should not take any drugs which contain esomeprazole.

Other drugs which may interact with omeprazole/ clarithromycin/ amoxicillin include the following:

  • Abemaciclib
  • Acalabrutinib
  • Acetaminophen / hydrocodone
  • Aspirin / hydrocodone
  • Astemizole
  • Atazanavir
  • Atazanavir / cobicistat
  • Atorvastatin
  • Atorvastatin / ezetimibe
  • Avanafil
  • Axitinib
  • Azelastine / fluticasone nasal
  • Bedaquiline
  • Belladonna / caffeine / ergotamine / pentobarbital
  • Brompheniramine / hydrocodone / phenylephrine
  • Budesonide
  • Caffeine / ergotamine
  • Carbamazepine
  • Carbinoxamine / hydrocodone / pseudoephedrine
  • Cariprazine
  • Ceritinib
  • Cerivastatin
  • Chlorpheniramine / guaifenesin / hydrocodone / pseudoephedrine
  • Citalopram
  • Colchicine
  • Crizotinib
  • Cyclosporine
  • Daclatasvir
  • Dasatinib
  • Deflazacort
  • Dexbrompheniramine / hydrocodone / phenylephrine
  • Dextromethorphan / quinidine
  • Edoxaban
  • Emtricitabine / nelfinavir / tenofovir
  • Eplerenone
  • Ergonovine
  • Ergotamine
  • Erythromycin
  • Erythromycin / sulfisoxazole
  • Escitalopram
  • Fentanyl
  • Fentanyl / ropivacaine
  • Fesoterodine
  • Fluticasone
  • Gatifloxacin
  • Guaifenesin / hydrocodone
  • Guaifenesin / hydrocodone / pseudoephedrine
  • Guanfacine
  • Halofantrine
  • Haloperidol
  • Hydrocodone
  • Ibuprofen / oxycodone
  • Ibutilide
  • Irinotecan
  • Irinotecan liposomal
  • Letrozole / ribociclib
  • Levomethadyl acetate
  • Lomitapide
  • Loperamide
  • Lovastatin
  • Mesoridazine
  • Methadone
  • Methotrexate
  • Methylprednisolone
  • Methysergide maleate
  • Mifepristone
  • Moxifloxacin
  • Naloxone / oxycodone
  • Naltrexone / oxycodone
  • Nelfinavir
  • Niacin / simvastatin
  • Olaparib
  • Osimertinib
  • Oxycodone
  • Papaverine
  • Pasireotide
  • Pseudoephedrine / terfenadine
  • Ranolazine
  • Ribociclib
  • Salmeterol
  • Sildenafil
  • Silodosin
  • Simvastatin
  • Tacrolimus
  • Thioridazine
  • Ticagrelor
  • Tolvaptan
  • Triamcinolone
  • Valbenazine
  • Vandetanib
  • Vardenafil
  • Vemurafenib
  • Venetoclax
  • Warfarin
  • Ziprasidone

Warnings

Before taking this product, tell your doctor or pharmacist if you are allergic to omeprazole, amoxicillin, or clarithromycin; or to penicillin (such as ampicillin), cephalosporins (such as cephalexin), or macrolide antibiotics (such as erythromycin); or to esomeprazole; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver disease (including liver problems with past clarithromycin use), kidney disease, heart disease (coronary artery disease, heart attack), a certain type of muscle disease (myasthenia gravis), a certain type of viral infection (infectious mononucleosis), lupus.

For patients taking omeprazole/ clarithromycin/ amoxicillin, there will be regular doctor visits scheduled so that the doctor can track the patient's progress. It is important for the doctor to determine whether the medication is working to relieve the ulcer condition, and to determine if continued use of omeprazole/ clarithromycin/ amoxicillin will be necessary. There may also be a variety of tests the doctor may choose to perform, including checking the blood or urine or other tests to see if there are any unwanted side effects being caused by the drug. For patients whose condition does not improve after treatment, or if a patient's condition gets worse, the patient should discuss the concern with the doctor as soon as possible.

Patients who are using omeprazole/ clarithromycin/ amoxicillin are cautioned not to use this medication with certain other ergot medications. These include drugs that contain ergotamine, dihydroergotamine, or pimozide. If the patient uses an ergot medication while taking the omeprazole/ clarithromycin/ amoxicillin combination drug, there is a risk of more serious side effects.

In some patients, using omeprazole/ clarithromycin/ amoxicillin could result in a severe allergic reaction, which could include anaphylaxis. Anaphylaxis is a potentially deadly condition in which the allergic reaction causes inability to breathe or other serious condition. This required immediate medical attention. While using omeprazole/ clarithromycin/ amoxicillin, patients should call their doctor immediately, or contact emergency services for a severe reaction, that includes any of the following symptoms: itching, rash, difficulty breathing or speaking or swallowing, having a hoarse voice, chills or fever, any type of ulcer or sore appearing on the skin, or unusual swelling in the face, mouth, throat or hands.

Patients who may be pregnant or who are attempting to get pregnant should inform their doctor before taking omeprazole/ clarithromycin/ amoxicillin. If a patient does become pregnant while taking omeprazole/ clarithromycin/ amoxicillin, she should inform her doctor immediately. The doctor may recommend changes to the dose of this medication.

Use of omeprazole/ clarithromycin/ amoxicillin can also lead to cases of diarrhea, even a severe bout. It is possible that the patient may experience this effect as much as two months or longer after he or she has stopped taking the drug. It is important that the patient not try to treat the diarrhea on their own with over the counter or other medications without first contacting the doctor. In cases where a mild form of diarrhea begins to get worse, patients should seek the advice of their doctor.

Patients should contact their doctor immediately for side effects such as joint pain, fever, a rash on the skin, swollen feet or ankles, or other areas of the body, or any abnormal weight gain while taking omeprazole/ clarithromycin/ amoxicillin. These side effects may be symptoms of a serious condition known as acute interstitial nephritis.

Taking omeprazole/ clarithromycin/ amoxicillin may also cause errors in some laboratory tests, such as a test for urine glucose, any may cause false results. It is important that the patient inform doctors and lab personnel that the patient is taking omeprazole/ clarithromycin/ amoxicillin.

Before taking this medication, patients of Asian descent should inform their doctor if they have relatives who are Asian, for example, relatives who are Chinese, Filipino, Korean, Japanese, or Taiwanese.

Patients should not use other drugs while taking omeprazole/ clarithromycin/ amoxicillin unless they have discussed their current medications with their doctor. This includes not only prescription medications, but also any nonprescription drugs, or over-the-counter drugs, as well as supplements or herbal remedies.

Storage

The omeprazole/ clarithromycin/ amoxicillin kit should be kept away from heat, moisture and light, at room temperature. This medication should be kept in a place safe from access by children or pets.

As with all medications, patients should properly dispose of any remaining medication or expired medications. For information about how to properly dispose of drugs, contact a healthcare or law enforcement professionals.

Summary

The drug combination of omeprazole/ clarithromycin/ amoxicillin is used to help patients suffering from gastrointestinal ulcers which have been caused by infections from a specific type of bacteria, the H. pylori bacteria. By combining these three drugs together, they work in combination to reduce stomach acid causing the ulcer (omeprazole) and at the same time treat the infection by stopping the growth of the bacteria that causes the infection (amoxicillin and clarithromycin). Patients maybe advised by their doctor to continue use of this medication in order to also prevent the infection from recurring, and this preventing the gastric ulcers. If this type of ulcer is left untreated, and the infection spreads, they can result in serious damage to the stomach or intestinal lining, as well as tearing or bleeding of the lining, or blockages in the system.

Omeprazole/ clarithromycin/ amoxicillin can be used by prescription only, and patients should not share this medication with anyone else. It comes in a kit containing a combination of capsules and tablets, some of which may be in a time-release form. Patients should be advised that there are many other medications which may have interactions with this drug, some of which can cause unwanted side effects. Before taking omeprazole/ clarithromycin/ amoxicillin, patients should provide a complete medical history, along with a list of all medications and supplements they are taking. The doctor can then determine if there are any changes needed to the prescription, or to the other medication being taken by the patient.

Patients should be aware of the most common side effects, such as a headache, a bad taste in the mouth, or having other changes in taste. Any other serious potential side effects may require the immediate attention of a doctor.