Amoxicillin/clarithromycin/omeprazole Disease Interactions
There are 13 disease interactions with amoxicillin / clarithromycin / omeprazole.
- Colitis
- C. diff
- Mononucleosis
- Diabetes
- PKU
- Renal dysfunction
- Hepatotoxicity
- Renal dysfunction
- Myasthenia gravis
- QT prolongation
- Hemodialysis
- Bone fractures
- Hypomagnesemia
Antibiotics (applies to amoxicillin/clarithromycin/omeprazole) colitis
Major Potential Hazard, Moderate plausibility. Applicable conditions: Colitis/Enteritis (Noninfectious), Colitis/Enteritis (Noninfectious)
Clostridioides difficile-associated diarrhea (CDAD), formerly pseudomembranous colitis, has been reported with almost all antibacterial drugs and may range from mild diarrhea to fatal colitis. The most common culprits include clindamycin and lincomycin. Antibacterial therapy alters the normal flora of the colon, leading to overgrowth of C difficile, whose toxins A and B contribute to CDAD development. Morbidity and mortality are increased with hypertoxin-producing strains of C difficile; these infections can be resistant to antimicrobial therapy and may require colectomy. CDAD must be considered in all patients who present with diarrhea after antibacterial use. Since CDAD has been reported to occur more than 2 months after antibacterial use, careful medical history is necessary. Therapy with broad-spectrum antibacterials and other agents with significant antibacterial activity should be administered cautiously in patients with history of gastrointestinal disease, particularly colitis; pseudomembranous colitis (generally characterized by severe, persistent diarrhea and severe abdominal cramps, and sometimes associated with the passage of blood and mucus), if it occurs, may be more severe in these patients and may be associated with flares in underlying disease activity. Antibacterial drugs not directed against C difficile may need to be stopped if CDAD is suspected or confirmed. Appropriate fluid and electrolyte management, protein supplementation, antibacterial treatment of C difficile, and surgical evaluation should be started as clinically indicated.
PPIs (applies to amoxicillin/clarithromycin/omeprazole) C. diff
Major Potential Hazard, Moderate plausibility. Applicable conditions: Pseudomembranous Colitis, Diarrhea
Published observational studies suggest that proton pump inhibitor (PPI) use may be associated with an increased risk of Clostridium difficile-associated diarrhea (CDAD), especially in hospitalized patients. This diagnosis should be considered for diarrhea that does not improve. It is recommended that patients should use the lowest dose and shortest duration of PPI therapy appropriate to the condition being treated. Close monitoring is recommended in patients with diarrhea and in those taking antibacterial agents as CDAD has been reported with the use of nearly all these agents. Treatment with antibacterial agents alters the normal flora of the colon, leading to overgrowth of C. difficile. C. difficile produces toxins A and B, which contribute to the development of CDAD. Appropriate fluid and electrolyte management, protein supplementation, antibiotic treatment of C. difficile, and surgical evaluation should be instituted as clinically indicated.
Aminopenicillins (applies to amoxicillin/clarithromycin/omeprazole) mononucleosis
Moderate Potential Hazard, Moderate plausibility.
Patients with mononucleosis treated with an aminopenicillin antibiotic, may develop a pruritic erythematous maculopapular skin rash. 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. Therapy with aminopenicillin antibiotics should not be administered in patients with mononucleosis.
Amoxicillin (applies to amoxicillin/clarithromycin/omeprazole) diabetes
Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Diabetes Mellitus
High urine concentrations of ampicillin may result in false-positive reactions when testing for the presence of glucose in urine using Clinitest®, Benedict's Solution or Fehling's Solution. Since this effect may also occur with amoxicillin, it is recommended that glucose tests based on enzymatic glucose oxidase reactions (such as Clinistix®) be used.
Amoxicillin (applies to amoxicillin/clarithromycin/omeprazole) PKU
Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Phenylketonuria
Some amoxicillin chewable tablets and suspensions products contain phenylalanine. The phenylalanine content should be considered when these products are used in patients who must restrict their intake of phenylalanine (i.e. phenylketonurics).
Beta-lactams (oral) (applies to amoxicillin/clarithromycin/omeprazole) renal dysfunction
Moderate Potential Hazard, High plausibility.
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.
Clarithromycin (applies to amoxicillin/clarithromycin/omeprazole) hepatotoxicity
Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Liver Disease
Hepatic dysfunction, including increased liver enzymes, and hepatocellular and/or cholestatic hepatitis, with or without jaundice, has been reported in patients receiving clarithromycin. The hepatic dysfunction may be severe but in most cases is reversible. Fatal outcomes have also been reported and in general have been associated with serious underlying diseases and/or concomitant medications. Caution and monitoring is advised if using this drug in patients with hepatic impairment. Treatment must be discontinued immediately if signs and symptoms of hepatitis occur (e.g., anorexia, jaundice, dark urine, pruritus, or tender abdomen). The use of clarithromycin and combination medications containing this antibiotic are contraindicated in patients with a history of cholestatic jaundice or hepatic impairment associated with the prior use of clarithromycin.
Clarithromycin (applies to amoxicillin/clarithromycin/omeprazole) renal dysfunction
Moderate Potential Hazard, Moderate plausibility.
Clarithromycin is primarily eliminated by the kidney and liver. A decreased dosage or prolonged dosing intervals are recommended 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 drug accumulation could occur in the presence of concomitant liver disease. Monitoring is advised.
Macrolide antibiotics (applies to amoxicillin/clarithromycin/omeprazole) myasthenia gravis
Moderate Potential Hazard, Moderate plausibility.
The use of macrolide antibiotics has been reported to exacerbate symptoms of myasthenia gravis and trigger new onset of symptoms of myasthenic syndrome. Therapy with these agents should be administered cautiously in patients with a history of myasthenia gravis.
Macrolide antibiotics (applies to amoxicillin/clarithromycin/omeprazole) QT prolongation
Moderate Potential Hazard, High plausibility. Applicable conditions: Hypokalemia, Magnesium Imbalance, Arrhythmias
Macrolides have been associated with prolongation of the QT interval and infrequent cases of arrhythmia. Clarithromycin and erythromycin should be avoided in: patients with known prolongation of the QT interval, ventricular cardiac arrhythmia, including torsades de pointes; patients with proarrhythmic conditions such as uncorrected hypokalemia or hypomagnesemia, clinically significant bradycardia, or receiving other drugs that prolong the QT interval.
Penicillins (applies to amoxicillin/clarithromycin/omeprazole) hemodialysis
Moderate Potential Hazard, High plausibility.
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.
Proton pump inhibitors (applies to amoxicillin/clarithromycin/omeprazole) bone fractures
Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Osteoporosis
Various published observational studies have reported that PPI therapy may be associated with an increased risk for osteoporosis related fractures of the hip, wrist or spine. The risk was increased in patients who received high doses (multiple daily doses), and long term treatment (a year or longer). Patients should use the lowest dose and shortest duration of PPI therapy appropriate to the condition being treated. Caution should be used in patients at risk for osteoporosis related fractures and should be managed according to established treatment guidelines.
Proton pump inhibitors (applies to amoxicillin/clarithromycin/omeprazole) hypomagnesemia
Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Magnesium Imbalance
Symptomatic and asymptomatic hypomagnesemia has been reported rarely in patients treated with PPIs for at least 3 months, in most cases after a year of therapy. Serious adverse events can include tetany, seizures, and arrhythmias. Caution should be used in patients prone to magnesium imbalances such as patients taking other medications that can cause hypomagnesemia (e.g., diuretics). Regular monitoring is recommended.
Amoxicillin/clarithromycin/omeprazole drug interactions
There are 803 drug interactions with amoxicillin / clarithromycin / omeprazole.
Amoxicillin/clarithromycin/omeprazole alcohol/food interactions
There is 1 alcohol/food interaction with amoxicillin / clarithromycin / omeprazole.
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Drug Interaction Classification
Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
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. | |
No interaction information available. |
Further information
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