Effect of omeprazole on the distribution of metronidazole, amoxicillin, and clarithromycin in human gastric juice

Af, Goddard; Jessa, M.J.; Barrett, David A.; Shaw, P. Nicholas; Idström, JP; Cederberg, Christer; Spiller, Robin C.

doi:10.1053/gast.1996.v111.pm8690200

Cited by 200 publications

(152 citation statements)

References 3 publications

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“…This is further supported by the finding that rabeprazole does not significantly change the gastric clearance and gastric transfer fraction of amoxicillin in the gastric juice. These results are similar to those found with another proton pump inhibitor, omeprazole, which potentiates amoxicillin monotherapy efficacy against H pylori by reducing the volume of gastric secretion and hence effectively increasing the drug concentration in the gastric juice [19] . The results in the present study indicate that small amounts of amoxicillin were transferred from the blood to the www.chinaphar.com Zheng HL et al Acta Pharmacologica Sinica npg gastric juice following intravenous administration.…”

Section: Amoxicillin Concentration In Gastric Mucosa and The Effect Osupporting

confidence: 84%

“…Gastric Transfer Fraction (%)=Gastric Clearance/Plasma Clearance Both parameters enable a description of the relative transfer of antibiotics across the gastric mucosa under different experimental conditions by correcting for intersubject variation in plasma antibiotic concentrations [19] .…”

Section: Calculations and Statisticsmentioning

confidence: 99%

“…An in vitro result reported that amoxicillin can be transported from the epithelial basal layer to the apical layer via paracellular transport or transcellular transport [26] . Several other data also indicate that amoxicillin is transported to the gastric mucosa or gastric juice [14,19,25,27,28] . In contrast, another report demonstrated that no amoxicillin was detected in gastric juice or gastric mucosa after intravenous administration [23,29] .…”

Section: Amoxicillin Concentration In Gastric Mucosa and The Effect Omentioning

confidence: 99%

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Transfer and distribution of amoxicillin in the rat gastric mucosa and gastric juice and the effects of rabeprazole

Zheng

Bao

et al. 2010

Acta Pharmacol Sin

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Aim: To investigate the distribution of amoxicillin in the gastric juice and gastric mucosa of rats and to investigate the effects of proton pump inhibitor rabeprazole on amoxicillin concentrations in various compartments. Methods: One hundred and sixty anesthetized rats were divided into five groups, and given intravenously different doses of amoxicillin or amoxicillin and rabeprazole. The pH value and volume of gastric juice was aspirated were measured and separated gastric mucosa was homogenized. The concentrations of amoxicillin in the plasma, gastric juice and gastric mucosa were measured by high performance liquid chromatography (HPLC). Results: The maximum concentrations of amoxicillin in gastric juice and gastric mucosa were significantly lower than those in plasma (P<0.001). Concentrations in the glandular stomach mucosa were higher than those in the forestomach mucosa. Rabeprazole did not significantly change the pharmacokinetic parameters of amoxicillin in the plasma and did not alter gastric antibiotic clearance or the gastric transfer fraction of amoxicillin in gastric juice. However, rabeprazole did increase the amoxicillin concentration and pH value in gastric juice and reduced the volume of the gastric juice. Conclusion: Amoxicillin could penetrate the gastric mucosa and achieve therapeutic concentrations at the target site after transfer from the blood to the stomach. Rabeprazole increased the amoxicillin concentration in gastric juice by decreasing the gastric juice volume but did not affect its concentration in blood or gastric mucosa.

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Section: Amoxicillin Concentration In Gastric Mucosa and The Effect Osupporting

confidence: 84%

Section: Calculations and Statisticsmentioning

confidence: 99%

Section: Amoxicillin Concentration In Gastric Mucosa and The Effect Omentioning

confidence: 99%

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Transfer and distribution of amoxicillin in the rat gastric mucosa and gastric juice and the effects of rabeprazole

Zheng

Bao

et al. 2010

Acta Pharmacol Sin

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“…In this study, the pharmacokinetic parameters of clarithromycin were comparable with those of other studies [23,24] . Early studies found that the AUC of CLR increased when omeprazole was given simultaneously with clarithromycin [7] , whereas only the T max was increased with lansoprazole coadministration [8] .…”

Section: Discussionsupporting

confidence: 89%

“…Mainz reported that the pharmacokinetics of amoxicillin were not altered by combination therapy with lansoprazole and clarithromycin [8] , which is consistent with other reports that demonstrated no effects of omeprazole on the pharmacokinetics of amoxicillin [21][22][23] . Therefore, in present study, we did not compare the plasma concentration of amoxicillin alone with combination therapy because of its non-metabolic characteristics.…”

Section: Discussionsupporting

confidence: 85%

Pharmacokinetic interactions between ilaprazole and clarithromycin following ilaprazole, clarithromycin and amoxicillin triple therapy

et al. 2012

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Aim: To investigate the drug interactions between ilaprazole, a new proton pump inhibitor, and clarithromycin following ilaprazole, clarithromycin and amoxicillin combination therapy. Methods: Twelve healthy Chinese volunteers were recruited in a randomized, open-label, 3-period crossover study. All subjects were administered ilaprazole (5 mg), clarithromycin (500 mg) or a triple therapy, including ilaprazole (5 mg), clarithromycin (500 mg) and amoxicillin (1 g), twice daily for 6 consecutive days. On the 7th day, the drugs were given once, and blood samples were collected and analyzed using a well-validated HPLC/MS/MS method. Results: Following the triple therapy, the peak concentration (C max ) and the area under the concentration-time curve from 0 h to 12 h (AUC 0→12 ) of ilaprazole were significantly decreased, as compared with the single medication group (C max : 1025.0±319.6 vs 1452.3±324.6 ng/mL; AUC 0→12 : 9777.7±3789.8 vs 11363.1±3442.0 ng· h/mL). Similar changes were found for ilaprazole sulfone (C max : 5.9±0.5 vs 9.3±1.7 ng/mL; AUC 0→12 : 201.4±32.1 vs 277.1±66.2 ng· h/mL). The triple therapy significantly elevated the C max of clarithromycin (3161.5±702.2 vs 2541.9±476.2 ng/mL). Conclusion:The H pylori eradication therapy with clarithromycin, amoxicillin and ilaprazole may cause pharmacokinetic interactions that decrease the amount of ilaprazole and its metabolites and elevate that of clarithromycin.

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Treatment of Helicobacter pylori Infection

Salcedo¹,

Al–Kawas²

1998

Arch Intern Med

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Since acceptance of the association between Helicobacter pylori and peptic ulcer disease, eradication of H. pylori has become the standard of care in the treatment of peptic ulcer disease. Unfortunately, eradication therapy is no easy task, especially when one is faced with a myriad of drug combinations with varying degrees of efficacy and tolerability. The following is a review of the literature regarding the drugs and drug combinations used to eradicate H. pylori and their effectiveness both as single agents and in combination.

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Effect of omeprazole on the distribution of metronidazole, amoxicillin, and clarithromycin in human gastric juice

Cited by 200 publications

References 3 publications

Transfer and distribution of amoxicillin in the rat gastric mucosa and gastric juice and the effects of rabeprazole

Transfer and distribution of amoxicillin in the rat gastric mucosa and gastric juice and the effects of rabeprazole

Pharmacokinetic interactions between ilaprazole and clarithromycin following ilaprazole, clarithromycin and amoxicillin triple therapy

Treatment of Helicobacter pylori Infection

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