Administration
Amoxicillin: May reduce the efficacy of OC. May increase the effect of anticoagulants. Increased risk of allergic reactions w/ allopurinol. Increased and prolonged blood levels w/ probenecid. Chloramphenicol, macrolides, sulfonamides and tetracyclines may interfere w/ the bactericidal effect of amoxicillin.
Clarithromycin: Serious adverse reactions have been reported in patients taking Clarithromycin concomitantly with CYP3A4 substrates. These include colchicine toxicity with colchicine; rhabdomyolysis with simvastatin, lovastatin, and atorvastatin; and hypotension and acute kidney injury with calcium channel blockers metabolized by CYP3A4 (e.g., verapamil, amlodipine, diltiazem, nifedipine). Most reports of acute kidney injury with calcium channel blockers metabolized by CYP3A4 involved elderly patients 65 years of age or older.
Lansoprazole: Increased risk of hypomagnesaemia w/ diuretics and digoxin. May decrease plasma concentration of erlotinib, dasatinib and lapatinib. May decrease the bioavailability of itraconazole and ketoconazole. May increase plasma concentration of cilostazol and methotrexate. Reduced bioavailability w/ antacids and sucralfate.
Potentially Fatal: May decrease serum levels and pharmacological effects of rilpivirine and atazanavir.
Pregnancy Category Note
>10%
Clarithromycin
GI effects, general (13%)
1-10%
Clarithromycin
Headache (6%),Rash (children 3%),Abdominal pain (adults 2%, children 3%),Abnormal taste (adults 3-7%),Diarrhea (3-6%),Dyspepsia (2%),Heartburn (adults 2%),GI intolerance (oral-dose related),Nausea (adults 3-6%),Vomiting (adults 1%; children 6%),Decreased WBC, elevated BUN (4%), elevated PT (1%)
Lansoprazole
Fatigue (< 3%),Headache (2.5-4.7%),Abdominal pain (1.8%),Diarrhea (8%),Nausea (3.7%)
<1%
Clarithromycin
QT prolongation,Anxiety, dizziness, hallucinations, manic behavior, neuromuscular blockade, psychosis, seizures,Anorexia, glossitis, pancreatitis,AST increased, bilirubin increased, elevated LFTs, hepatic dysfunction, hepatitis, increased alkaline phosphate, jaundice,Hypoglycemia, leukopenia, neutropenia, thrombocytopenia,Increased serum creatinine,Dyspnea,Anaphylaxis, C Diff colitis, Stevens-Johnson syndrome
Frequency Not Defined
Amoxicillin
Headache,Rash,Diarrhea, nausea, vomiting,Anemia,AST/ALT elevation,Acute exanthematous pustulosis,Exfoliative dermatitis
Seizure,Insomnia,Hemorrhagic colitis,Toxic epidermal necrolysis,Urticaria,Stevens-Johnson syndrome,Anaphylaxis,Candidiasis (mucocutaneous), pseudomembranous colitis, serum sickness
Clarithromycin
Torsade de pointes (rare),Allergic reactions: urticaria & skin eruptions, leukocytoclastic vasculitis, toxic epidermal necrolysis, pruritus, rash
Transient CNS effects: psychosis, anxiety, behavioral changes, confusional states, depersonalization, disorientation, hallucinations, insomnia, nightmares, tinnitus, tremor, and vertigo,Hepatic failure,Stomatitis,Acute renal failure,Reversible hearing loss (hypoacusis)