Generic Name: amoxicillin, clarithromycin, and lansoprazole (a MOX i SIL in, kla RITH roe MYE sin, LAN soe PRA zole)
Brand Name: Prevpac

What is Prevpac (amoxicillin, clarithromycin, and lansoprazole)?

Amoxicillin is a penicillin antibiotic. Clarithromycin is a macrolide antibiotic. These antibiotics fight bacteria in the body.

Lansoprazole decreases the amount of acid produced in the stomach.

Amoxicillin, clarithromycin, and lansoprazole is a combination medicine used in people with Helicobacter pylori (H. pylori) infection and stomach ulcers. Treating H. pylori infection can help prevent future stomach ulcers.

Amoxicillin, clarithromycin, and lansoprazole may also be used for purposes not listed in this medication guide.

What is the most important information I should know about Prevpac (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).

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Many drugs can interact with clarithromycin, and some can cause unwanted or dangerous effects when used at the same time. Tell your doctor about all medications you use, especially: cisapride, colchicine, pimozide, lovastatin, simvastatin, dihydroergotamine, ergotamine, ergonovine, or methylergonovine.

What should I discuss with my healthcare provider before taking Prevpac (amoxicillin, clarithromycin, and lansoprazole)?

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

  • an electrolyte imbalance (such as low levels of potassium or magnesium in your blood).

FDA pregnancy category C. It is not known whether amoxicillin, clarithromycin, and lansoprazole will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medicine.

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.

Do not give this medicine to anyone under 18 years old without medical advice.

How should I take Prevpac (amoxicillin, clarithromycin, and lansoprazole)?

Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Each dose of this combination medicine contains 4 pills (3 capsules and 1 tablet). Take all 4 pills twice daily before you eat, unless your doctor tells you otherwise.

Do not crush, chew, break, or open the pills. Swallow each pill whole. You may swallow the pills one at a time.

Use amoxicillin, clarithromycin, and lansoprazole for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Skipping doses may also increase your risk of further infection that is resistant to antibiotics. Amoxicillin, clarithromycin, and lansoprazole will not treat a viral infection such as the flu or a common cold.

This medicine can cause unusual results with certain lab tests for glucose (sugar) in the urine. Tell any doctor who treats you that you are using amoxicillin, clarithromycin, and lansoprazole.

Store at room temperature, away from moisture, heat, and light.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking Prevpac (amoxicillin, clarithromycin, and lansoprazole)?

If you also take sucralfate (Carafate), avoid taking it within 30 minutes after you take amoxicillin, clarithromycin, and lansoprazole. Sucralfate can make it harder for your body to absorb lansoprazole.

Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or has blood in it, call your doctor. Do not use any medicine to stop the diarrhea unless your doctor has told you to.

Prevpac (amoxicillin, clarithromycin, and lansoprazole) side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • diarrhea that is watery or bloody;

  • fever, swollen glands, body aches, flu symptoms;

  • skin rash, easy bruising or bleeding, severe tingling, numbness, pain, muscle weakness;

  • upper stomach pain, loss of appetite, dark urine, jaundice (yellowing of the skin or eyes);

  • irregular heart rhythm, feeling short of breath;

  • headache with chest pain and severe dizziness, fainting, fast or pounding heartbeats;

  • confusion, nausea and vomiting, swelling, rapid weight gain, urinating less than usual or not at all;

  • new or worsening cough with fever, trouble breathing; or

  • severe skin reaction--fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Serious side effects may be more likely in older adults.

Common side effects may include:

  • diarrhea, constipation;

  • headache;

  • vaginal itching or discharge;

  • nausea, vomiting, stomach pain;

  • unusual or unpleasant taste in the mouth; or

  • discolored teeth, black or "hairy" tongue.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

What other drugs will affect Prevpac (amoxicillin, clarithromycin, and lansoprazole)?

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);

  • 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.

Where can I get more information?

  • Your pharmacist can provide more information about amoxicillin, clarithromycin, and lansoprazole.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 5.01. Revision Date: 2014-05-27, 9:20:56 AM.

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