Esomeprazole is metabolized through the cytochrome P450 system, specially through the CYP3A isozymes. Studies have shown that Esomeprazole does not have clinically significant interactions with other drugs metabolized by the cytochrome P450 system, such as warfarin, antipyrine, indomethacin, ibuprofen, phenytoin, propranolol, prednisolone, diazepam, clarithromycin or terfenadine in healthy subject.
Clarithromycin use in patients who are receiving theophylline may be associated with an increase of serum theophylline concentrations.
There have been reports of interactions of clarithromycin with carbamazepine, cyclosporine, tactrolimus, hexobarbital, phenytoin, alfetanil, disopyramide, lovastatin, bromocriptine, valproate, terfenadine, cisapride, pimozide & astemizole.
H. pylori eradication therapy is generally well tolerated. Adverse events reported during clinical trials were not unexpected given the component substances. Common adverse reactions included diarrhoea and nausea.
This should only be given to pregnant women if its use is considered essential. The safety of this combination for use during breast feeding of infants has not been established.
Serious and occasionally fatal hypersensitivity reactions have been reported in patients on Amoxicillin therapy. These reactions are more apt to occur in indivduals with a history of penicillin hypersensitivity. Clarithromycin should not used in pregnant women except in clinical circumstances where no alternative is appropriate.
GERIATRIC USE: Although this regimen has not been specifically studied in the elderly, dosage adjustment is not needed during therapy with individual components. It is therefore unlikely to require dosage adjustment with this combination
Anti H. pylori drugs
Store in a cool (below 30 degree C) and dry place.