Amoxicillin / clarithromycin / lansoprazole Disease Interactions
There are 8 disease interactions with amoxicillin / clarithromycin / lansoprazole:
- Renal Dysfunction
- Renal Dysfunction
- Liver Disease
- Myasthenia Gravis
Patients with mononucleosis treated with an aminopenicillin antibiotic, particularly ampicillin, quite frequently develop a pruritic erythematous maculopapular skin rash that generally occurs 5 to 10 days after therapy is initiated. The rash is usually self-limiting and resolves within days of discontinuing the offending agent. An altered drug metabolism or an immune-mediated process unrelated to drug hypersensitivity has been proposed as the underlying mechanism. Clinicians should recognize that a skin eruption under this circumstance does not necessarily indicate a life-long allergy to these agents or other penicillin derivatives. Therapy with aminopenicillin antibiotics may not be appropriate in patients with mononucleosis.
- "Product Information. Polycillin (ampicillin)." Apothecon Inc, Plainsboro, NJ.
- Adcock BB, Rodman DP "Ampicillin-specific rashes." Arch Fam Med 5 (1996): 301-4
- Marra CA, Shalansky KF "Ampicillin-induced macropapular versus urticarial rash." Ann Pharmacother 30 (1996): 401-2
Augmentin (brand of amoxicillin-clavulanate) chewable tablets contain 2.1 mg of phenylalanine per each 200 mg tablet and 4.2 mg of phenylalanine per each 400 mg tablet. Augmentin oral suspension contains 7 mg of phenylalanine per each 5 mL of reconstituted suspension for both the 200 mg/5 mL and 400 mg/5 mL strengths. The phenylalanine content should be considered when these products are used in patients who must restrict their intake of phenylalanine (i.e. phenylketonurics).
- "Product Information. Augmentin (amoxicillin-clavulanate)." SmithKline Beecham, Philadelphia, PA.
Pseudomembranous colitis has been reported with most antibacterial agents and may range in severity from mild to life-threatening, with an onset of up to two months following cessation of therapy. Antibiotic therapy can alter the normal flora of the colon and permit overgrowth of Clostridium difficile, whose toxin is believed to be a primary cause of antibiotic-associated colitis. The colitis is usually characterized by severe, persistent diarrhea and severe abdominal cramps, and may be associated with the passage of blood and mucus. The most common culprits are clindamycin, lincomycin, the aminopenicillins (amoxicillin, ampicillin), and the cephalosporins. Therapy with broad-spectrum antibiotics and other agents with significant antibacterial activity should be administered cautiously in patients with a history of gastrointestinal diseases, particularly colitis. There is some evidence that pseudomembranous colitis, if it occurs, may run a more severe course in these patients and that it may be associated with flares in their underlying disease activity. The offending antibiotic(s) should be discontinued if significant diarrhea occurs during therapy. Stool cultures for Clostridium difficile and stool assay for C. difficile toxin may be helpful diagnostically. A large bowel endoscopy may be considered to establish a definitive diagnosis in cases of severe diarrhea.
- Moriarty HJ, Scobie BA "Pseudomembranous colitis in a patient on rifampicin and ethambutol." N Z Med J 04/23/80 (1980): 294-5
- Dan M, Samra Z "Clostridium difficile colitis associated with ofloxacin therapy." Am J Med 87 (1989): 479
- Meadowcroft AM, Diaz PR, Latham GS "Clostridium difficile toxin-induced colitis after use of clindmycin phosphate vaginal cream." Ann Pharmacother 32 (1998): 309-11
Most beta-lactam antibiotics are eliminated by the kidney as unchanged drug and, in some cases, also as metabolites. The serum concentrations of beta-lactam antibiotics and their metabolites may be increased and the half-lives prolonged in patients with impaired renal function. Dosage adjustments may be necessary and modifications should be based on the degree of renal impairment as well as severity of infection in accordance with the individual product package labeling. Renal function tests should be performed periodically during prolonged and/or high-dose therapy, since nephrotoxicity and alterations in renal function have occasionally been associated with the use of these drugs.
- "Product Information. Geocillin (carbenicillin)." Roerig Division, New York, NY.
- DeSante KA, Zeckel ML "Pharmacokinetic profile of loracarbef." Am J Med 92 (1992): s16-9
- "Product Information. Suprax (cefixime)." Lupin Pharmaceuticals Inc, Baltimore, MD.
Clarithromycin and its primary, active metabolite are both eliminated by the kidney to some extent. The daily dosage should be halved in patients with severe renal impairment (CrCl < 30 mL/min). Dosage adjustments are usually not necessary in patients with mild to moderate renal impairment, although theoretically, drug accumulation could occur in these patients if they have concomitant liver disease.
- Hardy D, Guay D, Jones R "Clarithromycin, a unique macrolide." Diagn Microbiol Infect Dis 15 (1992): 39-53
- "Product Information. Biaxin (clarithromycin)." Abbott Pharmaceutical, Abbott Park, IL.
- Davey PG "The pharmacokinetics of clarithromycin and its 14-OH metabolite." J Hosp Infect 19 (1991): 29-37
Lansoprazole is primarily metabolized by the liver. Although the drug is generally well-tolerated, dosage adjustments with cautious titration should be considered in patients with severe hepatic impairment.
- "Product Information. Prevacid (lansoprazole)." TAP Pharmaceuticals Inc, Deerfield, IL.
- Pichard L, Curi-Pedrosa R, Bonfils C, Jacqz-Aigrain E, Domergue J, Joyeux H, Cosme J, Guengerich FP, Maurel P "Oxidative metabolism of lansoprazole by human liver cytochromes P450." Mol Pharmacol 47 (1995): 410-8
- Spencer CM, Faulds D "Lansoprazole. A reappraisal of its pharmacodynamic and pharmacokinetic properties, and its therapeutic efficacy in acid- related disorders." Drugs 48 (1994): 404-30
The use of macrolide antibiotics has been reported to exacerbate symptoms of myasthenia gravis and trigger new onset of symptoms of myasthenic syndrome. Limited data suggest presynaptic suppression of acetylcholine release. Therapy with these agents should be administered cautiously in patients with a history of myasthenia gravis.
- May EF, Calvert PC "Aggravation of myasthenia gravis by erythromycin." Ann Neurol 28 (1990): 577-9
- "Product Information. Ery-tab (erythromycin)." Abbott Pharmaceutical, Abbott Park, IL.
Penicillin antibiotics (except for agents in the penicillinase-resistant class) are removed by hemodialysis. Doses should either be scheduled for administration after dialysis or supplemental doses be given after dialysis.
- Francke EL, Appel GB, Neu HC "Kinetics of intravenous amoxicillin in patients on long-term dialysis." Clin Pharmacol Ther 26 (1979): 31-5
- Davies BE, Boon R, Horton R, Reubi FC, Descoeudres CE "Pharmacokinetics of amoxycillin and clavulanic acid in haemodialysis patients following intravenous administration of augmentin." Br J Clin Pharmacol 26 (1988): 385-90
- Blum RA, Kohli RK, Harrison NJ, Schentag JJ "Pharmacokinetics of ampicillin (2.0 grams) and sulbactam (1.0 gram) coadministered to subjects with normal and abnormal renal function and with end-stage renal disease on hemodialysis." Antimicrob Agents Chemother 33 (1989): 1470-6
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amoxicillin / clarithromycin / lansoprazole drug Interactions
There are 837 drug interactions with amoxicillin / clarithromycin / lansoprazole
amoxicillin / clarithromycin / lansoprazole alcohol/food Interactions
There is 1 alcohol/food interaction with amoxicillin / clarithromycin / lansoprazole
Drug Interaction Classification
The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.
|Major||Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.|
|Moderate||Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.|
|Minor||Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.|
Do not stop taking any medications without consulting your healthcare provider.
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