Pharmacokinetic and pharmacodynamic interactions between omeprazole and amoxycillin in Helicobacter pylori‐positive healthy subjects.

Pommerien, W.; Braun, Marina; Idström, JP; Wrangstadh, Michael; Londong, W.

doi:10.1111/j.0953-0673.1996.00295.x

Cited by 13 publications

(6 citation statements)

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“…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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Section: Discussionsupporting

confidence: 85%

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

et al. 2012

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“…The drug regimen should be based susceptibility testing using biopsies from the patient, stool specimens, or more commonly by knowledge of the success rates of different therapies in the local area and in one's practice. Other considerations include cost and availability of drugs and should take into account the difference in pharmacokinetics and pharmacodynamics of the drugs available [25][26][27][28][29] .…”

Section: Host Factors Influencing Treatment Successmentioning

confidence: 99%

New concepts of resistance in the treatment of Helicobacter pylori infections

Graham

Shiotani

2008

Nat Rev Gastroenterol Hepatol

315

368

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SummaryThe prevalence of antimicrobial resistance is now such that all patients should be considered as having resistant infections. Ideally therapy is based on pretreatment susceptibility testing. Empiric therapies should assume antimicrobial resistance and use higher doses for 14 days. Acceptable results are 90-94% cure intention to treat (Grade B) or greater. Clarithromycin-containing triple therapies now typically produce ≤80% cure ITT (Grade F) and are no longer acceptable empiric therapy. Current initial therapy options are between sequential therapy, concomitant therapy, and bismuth containing quadruple therapy. Sequential therapy has the potential to be improved to ≥95% cure ITT (Grade A) by continuing the amoxicillin through the second and/or by increasing the duration. Better appreciation of the role of acidity in phenotypic resistance has resulted in high cure rates with high dose PPI plus amoxicillin dual therapy; additional studies to devise better dual-based multidrug regimes are still needed. Antimicrobial choices following treatment failure is best approached by susceptibility testing. If not available, we recommended a bismuth containing quadruple therapy substituting a new drug for metronidazole/tinidazole and/or clarithromycin if they have been used previously. The alternate would be to use a 14 day high dose PPI, amoxicillin-based triple therapy with rifabutin, a fluoroquinolone, or furazolidone. KeywordsHelicobacter pylori; therapy; resistance; antibiotics; anti-secretory drugs; phenotypic drug resistance; cytochrome P450 "To read without reflecting is like eating without digesting". -86-462-1111-86-462- , FAX 81-86-464-1195 Review criteria: We searched the relevant papers by using computer-assisted bibliographic searches of PubMed through November 30, 2007 using combinations of the following terms: H. pylori combined with resistance, therapy, eradication, second, triple, quadruple, sequential, or rescue. We also reviewed the recent literature on pharmacokinetics and pharmacodynamics in relation to the drugs used in H. pylori therapy and the relation to host cytochrome P450 genotypes to treatment outcome. We did not perform meta-analyses. We reviewed only articles published in English.

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“…Omeprazole was launched as the fi st PPI in the United States under license by Merck, Sharp & Dohme (West Point, Pennsylvania) in 1989 [ 2 ] . It has been playing an dominant role in clinical treatment of the acid-related disorder diseases and combined regimen against Helicobacter pylori compared with other PPIs during the past decade [ 3 ] . However, omeprazole is acid-labile and decomposes rather rapidly at pH < 5 [ 4 ] .…”

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confidence: 99%

Pharmacokinetics of a New Immediate-release Compound Omeprazole Capsule and its Comparison with the Enteric-coated Formulation under Fasting and Fed Conditions

et al. 2013

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The present study was conducted to describe the pharmacokinetic profile of immediate-release compound omeprazole capsule and compare it with the enteric-coated formulation under fasting and fed condition.This study was designed to phase I, open-label, randomized, 3-part clinical trial. 12 subjects in part one received single doses (20 mg and 40 mg) and repeated doses (20 mg). Different 30 subjects in part 2 (fasting condition) and part 3 (fed condition) received either compound omeprazole capsule (40 mg) or delayed-release omeprazole (40 mg) separated by 7 days.Compound omeprazole capsule showed dose non-proportionality in the range from 20 mg to 40 mg. The AUC0-t of 20 mg omeprazole is 78% higher after repeated doses. The C max was higher and T max was lower for compound omeprazole capsule than delayed-release omeprazole. 90% CIs for AUC0-t of the 2 periods (test/reference) under fasting and fed conditions were 106.3% (102.2%~109.2%) and 104.1% (93.4%~109.6%), respectively. Presence of food reduced the rate (C max) and extent (AUC0-t) of systemic exposure of the test and reference formulations from 1 462 to 777 ng · mL-1, 1 055 to 602 ng · mL-1, 2 597 to 1 852 ng · h · mL-1 and 2 454 to 1 873 ng · h · mL-1, respectively.Exposed dose of omeprazole in subjects with compound omeprazole capsule was time- and dose-dependent. Compared with delayed-release omeprazole, compound omeprazole capsule had rapid but similar degree of absorption of omeprazole.

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Pharmacokinetic and pharmacodynamic interactions between omeprazole and amoxycillin in Helicobacter pylori‐positive healthy subjects.

Abstract: High-dose omeprazole does not alter the pharmacokinetics of amoxycillin. The significantly lower intragastric pH during combination therapy might be due to the H. pylori-suppressive effect of this treatment.

Cited by 13 publications

References 0 publications

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

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

New concepts of resistance in the treatment of Helicobacter pylori infections

Pharmacokinetics of a New Immediate-release Compound Omeprazole Capsule and its Comparison with the Enteric-coated Formulation under Fasting and Fed Conditions

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