Generic
Omeprazole + Metronidazole + Clarithromycin
1 brands available in the market
At a glance
Omeprazole + Metronidazole + Clarithromycin is a triple therapy kit used for the treatment of H. pylori infection. Omeprazole reduces stomach acid, Metronidazole and Clarithromycin are antibiotics that kill H. pylori bacteria.
Description
This triple therapy kit contains Omeprazole (20 mg), Metronidazole (400 mg) and Clarithromycin (250 mg). Omeprazole is a PPI that blocks the final step of gastric acid production. Metronidazole interacts with DNA to destroy helical DNA structure and cause cell death. Clarithromycin binds to 50S ribosomal subunits to inhibit protein synthesis. Together, these three medicines eradicate H. pylori infection and help heal peptic ulcers.
Indications
H. pylori infection (associated with peptic ulcer disease).
Therapeutic class
Anti-H. pylori Drugs (Triple Therapy)
Pharmacological class
Proton Pump Inhibitor + Nitroimidazole Antibiotic + Macrolide Antibiotic
Pharmacology
Omeprazole inhibits the final step of gastric acid secretion by blocking the H+/K+ ATPase enzyme system in gastric parietal cells. Metronidazole is converted to reduction products that interact with DNA to cause destruction of helical DNA structure and strand breakage, leading to protein synthesis inhibition and cell death. Clarithromycin inhibits protein synthesis by penetrating the cell wall and binding to 50S ribosomal subunits.
Mechanism of action
Omeprazole reduces stomach acid to enhance antibiotic efficacy. Metronidazole destroys bacterial DNA and Clarithromycin inhibits bacterial protein synthesis. Together, these three medicines eradicate H. pylori infection and help heal peptic ulcers.
Dosage
Adult Dose: Twice daily (morning and evening) for 7-14 days. Each kit contains: Omeprazole 20 mg + Clarithromycin 250 mg + Metronidazole 400 mg.
Administration
Take at least 1 hour before meals on an empty stomach (omeprazole works best on empty stomach). Swallow tablets/capsules whole; do not chew or crush. Complete the full course (7-14 days).
Missed dose
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double the dose.
Side effects
Common side effects: Nausea, vomiting, diarrhea, abdominal pain, headache, dizziness, dry mouth, dark stools, stomatitis, myalgia, confusion, vaginitis.
Serious side effects: Allergic reactions (rash, itching, swelling of face, difficulty breathing), severe diarrhea, liver problems (jaundice, dark urine), QT prolongation (irregular heartbeat).
Precautions & warnings
Serious and occasional hypersensitivity reactions may occur (especially in patients with history of penicillin allergy). Elderly patients have higher risk of hepatic and renal impairment. Avoid alcohol during treatment. Unsafe during pregnancy. Complete the full course even if you feel better.
Contraindications
Hypersensitivity to any component.
Drug interactions
Omeprazole: Reduces antiplatelet effect of clopidogrel. Decreases plasma concentrations of rilpivirine, atazanavir, nelfinavir. Increases INR and prothrombin time with warfarin. Increases risk of digoxin cardiotoxicity. Increases risk of hypomagnesemia with diuretics. Delays elimination of diazepam, phenytoin, cilostazol, cyclosporine. Decreases absorption of ketoconazole, itraconazole, iron salts.
Metronidazole: Psychotic reactions with disulfiram. Potentiates oral anticoagulants. Increases lithium toxicity. Increases 5-fluorouracil toxicity. Increases serum levels of cyclosporine and busulfan. Enhanced metabolism with phenobarbital and phenytoin (decreased serum concentrations).
Clarithromycin: Reduced efficacy with CYP3A inducers (phenytoin, carbamazepine). Rifampicin lowers clarithromycin plasma levels. Ritonavir inhibits metabolism. Quinidine or disopyramide may cause torsades de pointes. Increased phosphodiesterase inhibitor exposure (sildenafil, tadalafil, vardenafil). Increased digoxin toxicity. Decreased zidovudine concentration. Bidirectional interactions with atazanavir, itraconazole, saquinavir. Hypotension, bradyarrhythmias, lactic acidosis with verapamil. Increased myopathy risk with HMG-CoA reductase inhibitors. Increased hypoglycemia with oral hypoglycemics and insulin. Increased INR and prothrombin time with oral anticoagulants (serious hemorrhage risk). Increased ototoxicity with aminoglycosides. Increased sedation with triabenzodiazepines (midazolam). Potentially Fatal: Acute ergot toxicity with ergotamine/dihydroergotamine (vasospasm, ischemia). QT prolongation or ventricular arrhythmia with astemizole, cisapride, pimozide, terfenadine.
Food interactions
Caution advised when consuming alcohol (metronidazole may cause disulfiram-like reaction). Avoid alcohol during treatment and for 2-3 days after completion.
Use in pregnancy
Unsafe during pregnancy. Use only if clearly needed under medical supervision.
Pregnancy Category: C — always consult a doctor before taking during pregnancy.
Use in lactation
Caution during lactation. Metronidazole passes into breast milk.
Pediatric use
Safety and efficacy not established in children.
Geriatric use
Elderly patients have higher risk of hepatic and renal impairment; caution required.
Renal / hepatic impairment
Caution in renal impairment (metronidazole and clarithromycin dose adjustment may be needed). Caution in hepatic impairment (omeprazole dose may need reduction).
Overdose effects
Symptoms of overdose: nausea, vomiting, diarrhea, headache, dizziness, confusion. Seek medical attention immediately if overdose is suspected.
Storage conditions
Store below 30°C in a cool and dry place, protected from light. Keep out of reach of children.
Chemical structure
Omeprazole 20 mg + Metronidazole 400 mg + Clarithromycin 250 mg