Indications

This medication is indicated for the eradication of H. pylori in patients with active chronic gastric, duodenal, and gastric ulcers.

Pharmacology

This is a combination therapy with three components:

• Lansoprazole: A proton-pump inhibitor that suppresses gastric acid production by inhibiting the stomach's acid pump.
• Amoxicillin: A penicillin antibiotic that inhibits the synthesis of bacterial cell walls, specifically by preventing cross-linkage between peptidoglycan polymer chains.
• Clarithromycin: A macrolide antibiotic that prevents bacterial growth by interfering with their protein synthesis. It binds to the 50S subunit of the bacterial ribosome.

Dosage & Administration

• Adults: One strip twice daily for 7-14 days, or as advised by a physician.
• Geriatric use: Elderly patients may have renal and hepatic dysfunction, so care should be taken when administering the drug.

Interaction

• Lansoprazole: Metabolized by the cytochrome P450 system, but does not have clinically significant interactions with drugs like warfarin, ibuprofen, phenytoin, or clarithromycin.
• Clarithromycin: May increase the serum concentration of theophylline. It has also been reported to interact with a number of other drugs, including carbamazepine, cyclosporine, and certain heart medications.

Contraindications

This medication is contraindicated in patients with a known hypersensitivity to any of its components.

Side Effects

Reported side effects (in more than 3% of patients) include:

• Digestive system: Nausea, vomiting, diarrhea, dark stools, dry mouth, and oral infections (moniliasis, stomatitis).
• Musculoskeletal System: Myalgia (muscle pain).
• Nervous System: Confusion, headache, and dizziness.
• Skin: Skin reactions.
• Urogenital System: Vaginitis and vaginal moniliasis.

Pregnancy & Lactation

There are no adequate and well-controlled studies in pregnant women. This medication should only be used during pregnancy if the potential benefit justifies the potential risk to the mother. Amoxicillin is excreted in human milk in small amounts. A decision on whether to discontinue nursing or the drug should be made based on the importance of the therapy to the mother.

Precautions & Warnings

Serious and occasionally fatal hypersensitivity (anaphylactoid) reactions have been reported with Amoxicillin therapy, especially in individuals with a history of penicillin hypersensitivity. Clarithromycin should not be used in pregnant women unless no other therapy is appropriate.

Therapeutic Class

This is an Anti H. pylori drug.

Storage Conditions

Store in a cool and dry place, protected from light.