How does this medication work? What will it do for me?

This is a product that contains three separate medications: lansoprazole, clarithromycin, and amoxicillin. Lansoprazole belongs to the group of medications called proton pump inhibitors (PPIs). Clarithromycin and amoxicillin belong to the group of medications called antibiotics. Together these medications are used to treat H. pylori (bacteria that cause inflammation in the stomach) for people with a duodenal ulcer (an ulcer at the beginning of the small intestine).

These medications are also used to reduce the risk of another duodenal ulcer occurring for people who have recently had a duodenal ulcer and who have tested positive for H. pylori. Lansoprazole helps to lower the acidity of the stomach, which helps the antibiotics (clarithromycin and amoxicillin) kill the bacteria and to heal the ulcer.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

Each triple therapy HP-PAC (lansoprazole - clarithromycin - amoxicillin) daily administration blister pack contains:

Lansoprazole 30 mg
Each opaque, hard gelatin, pink and black, delayed-release capsule, with the TAP logo and "PREVACID 30" imprinted on the capsule, contains lansoprazole 30 mg. Nonmedicinal ingredients: cellulosic polymers, colloidal silicon dioxide, D&C Red No. 28, FD&C Blue No. 1, FD&C Red No. 40, gelatin, magnesium carbonate, methacrylic acid copolymer, polyethylene glycol, polysorbate 80, starch, sucrose, sugar spheres, talc, and titanium dioxide.

Clarithromycin 500 mg
Each pale yellow, oval, film-coated tablet, with the Abbott logo printed on one side, contains clarithromycin 500 mg. Nonmedicinal ingredients: cellulosic polymers, croscarmellose sodium, D&C Yellow No. 10, magnesium stearate, povidone, propylene glycol, silicon dioxide, sorbic acid, sorbitan monooleate, stearic acid, talc, titanium dioxide, and vanillin. Tartrazine-free.

Amoxicillin 500 mg
Each opaque, scarlet and yellow capsule, with the Abbott logo and "500" imprinted on the capsule, contains amoxicillin trihydrate 500 mg. Nonmedicinal ingredients: colloidal silicon dioxide, D&C Yellow No. 10, dry-flo starch, FD&C Blue No. 1, FD&C Red No. 3, FD&C Red No. 40, FD&C Yellow No. 6, gelatin, magnesium stearate, sodium lauryl sulfate, talc, and titanium dioxide. Gluten- and tartrazine-free.

How should I use this medication?

The usual adult dose of this combination of medications is 30 mg of lansoprazole, 500 mg of clarithromycin and 1 g (two 500 mg capsules) of amoxicillin, twice a day before meals for 7, 10, or 14 days.

Lansoprazole capsules should be swallowed whole with water – do not crush or chew them.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take this medication exactly as prescribed by your doctor and to finish all this medication. Not doing so may decrease the effectiveness of this medication and may increase the chances of bacteria developing resistance to amoxicillin and clarithromycin.

If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not take this medication if you:

  • are allergic to lansoprazole, clarithromycin, amoxicillin, or any ingredients of these medications
  • are allergic to other penicillins (e.g., cloxacillin, penicillin), cephalosporins, or other macrolide antibiotics (e.g., erythromycin, azithromycin)
  • are taking astemizole, terfenadine, cisapride, pimozide, ergotamine, or dihydroergotamine
  • have or may have mononucleosis

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • burping
  • constipation
  • diarrhea
  • difficulty sleeping
  • dry mouth
  • gas
  • headache
  • heartburn or indigestion
  • muscle pain
  • nausea
  • rash
  • taste changes
  • vomiting
  • weakness

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • abdominal pain
  • irregular heartbeat
  • lightheadedness or dizziness
  • severe abdominal pain or cramps
  • severe diarrhea with or without blood or mucus
  • symptoms of a bladder infection (pain or burning when urinating)
  • symptoms of an upper airway infection such as cough, nasal congestion, sinus pain, runny nose, or sore throat

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • abnormal heart rhythms (such as fast or slow heart rate, palpitations), fainting or seizures
  • signs of an allergic reaction (e.g., hives; difficulty breathing; swelling of the face, mouth, tongue, or throat)
  • signs of a severe skin reaction such as blistering, peeling, a rash covering a large area of the body, a rash that spreads quickly, or a rash combined with fever or discomfort

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin taking a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should take this medication.

Allergic reactions: Some people who are allergic to penicillin or cephalosporins also experience allergic reactions to amoxicillin. Some people who are allergic to erythromycin or azithromycin also experience allergic reactions to clarithromycin. Before you take lansoprazole - clarithromycin - amoxicillin, inform your doctor about any previous adverse reactions you have had to medications, especially penicillin or erythromycin antibiotics. Contact your doctor at once if you experience signs of an allergic reaction, such as skin rash, itching, difficulty breathing, or swelling of the face and throat.

Diarrhea: Diarrhea is a common side effect of antibiotics such as amoxicillin and clarithromycin. Diarrhea usually stops when the antibiotic is finished. However, a serious condition called pseudomembranous colitis can occur. If you develop severe watery and bloody diarrhea (with or without stomach cramps and fever) any time during treatment or up to 1 or 2 months after stopping this medication, contact your doctor.

Kidney function: A safe and effective dose of lansoprazole - clarithromycin - amoxicillin for people with reduced kidney function has not been determined. If you have kidney disease or decreased kidney function, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Liver function: Liver disease or reduced liver function may cause clarithromycin or lansoprazole to build up in the body, causing side effects. If you have liver problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Your doctor may want to test your liver function regularly with blood tests while you are taking this medication.

Methotrexate: When taken together, proton pump inhibitors such as lansoprazole may cause methotrexate to build up in the body, causing severe side effects, including possible death. Methotrexate is used to treat certain types of cancer, arthritis, and gastrointestinal disease. If you are taking methotrexate for any reason, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Stomach cancer: Lansoprazole can improve some of the symptoms of stomach cancer and make it harder for a doctor to diagnose it.

Pregnancy: This medication should not be used during pregnancy, especially during the first 3 months, unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast feeding: Amoxicillin and clarithromycin pass into breast milk. It is not known if lansoprazole passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this combination of medications have not been established for children.

Seniors: Due to the possibility of reduced kidney and liver function, seniors should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

What other drugs could interact with this medication?

There may be an interaction between lansoprazole - clarithromycin - amoxicillin and any of the following:

  • alfentanil
  • alfuzosin
  • allopurinol
  • almotriptan
  • alprazolam
  • amiodarone
  • ampicillin
  • anti-psychotic medications (e.g., clozapine, quetiapine, risperidone, ziprasidone)
  • anti-rejection medications (e.g., pimecrolimus, sirolimus, tacrolimus)
  • aprepitant
  • aripiprazole
  • atazanavir
  • azole anti-fungals (e.g., ketoconazole, itraconazole)
  • BCG
  • benzodiazepines (e.g., alprazolam, chlordiazepoxide, clonazepam, clorazepate, diazepam, flurazepam, midazolam, triazolam)
  • certain beta-blockers (e.g., carvedilol, nadolol)
  • birth control pills
  • bisphosphonates (e.g., alendronate, etidronate)
  • bosutinib
  • brinzolamide
  • bromocriptine
  • buspirone
  • calcium channel blockers (e.g., amlodipine, diltiazem, nifedipine)
  • carbamazepine
  • cetirizine
  • chloral hydrate
  • chloroquine
  • ciclesonide
  • cisapride
  • clopidogrel
  • colchicine
  • corticosteroids (e.g., budesonide, methylprednisolone, prednisolone, prednisone)
  • cyclosporine
  • dabigatran
  • dasatinib
  • deferasirox
  • delavirdine
  • didanosine
  • digoxin
  • disopyramide
  • divalproex
  • domperidone
  • dronedarone
  • eletriptan
  • ergot derivatives (e.g., dihydroergotamine, ergotamine)
  • etravirine
  • everolimus
  • fentanyl
  • flecainide
  • fluoroquinolone antibiotics (e.g., ciprofloxacin, ofloxacin, moxifloxacin)
  • gadobutrol
  • granisetron
  • H2-blockers (e.g., famotidine, ranitidine)
  • ifosfamide
  • imatinib
  • indapamide
  • indinavir
  • iron
  • other macrolide antibiotics (e.g., azithromycin, erythromycin)
  • maraviroc
  • mesalamine
  • methadone
  • methotrexate
  • methylphenidate
  • mifepristone
  • mycophenolate
  • nelfinavir
  • nilotinib
  • ondansetron
  • pentamidine
  • phenytoin
  • phosphoesterase 5 inhibitors (e.g., sildenafil, vardenafil)
  • pimozide
  • probenecid
  • protease inhibitors (e.g., indinavir, ritonavir, saquinavir)
  • quinidine
  • quinine
  • rifabutin
  • rifampin
  • rivaroxaban
  • salmeterol
  • saxagliptin
  • selective serotonin reuptake inhibitors (SSRIs; e.g., citalopram, fluoxetine, paroxetine, sertraline)
  • silodosin
  • St. John's wort
  • "statin" cholesterol medications (e.g., atorvastatin, lovastatin, simvastatin)
  • sucralfate
  • sulfamethoxazole
  • sulfonylureas (e.g., glipizide, glyburide)
  • tamoxifen
  • tamsulosin
  • tetracycline antibiotics (e.g., doxycycline, tetracycline)
  • theophylline
  • tocilizumab
  • tolterodine
  • topotecan
  • tramadol
  • trazodone
  • triazolam
  • tricyclic antidepressants (e.g., amitriptyline, imipramine, nortriptyline)
  • trimethoprim
  • typhoid vaccine
  • valproate
  • venlafaxine
  • vinblastine
  • vincristine
  • warfarin
  • zidovudine
  • zopiclone

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.