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GASTROINTESTINAL - H. pylori Treatment (Helicobacter pylori) Numerous regimens are generally equally effective, but vary in tolerability, convenience, duration, and cost.
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Regimen #1 (3 Drugs)
Lansoprazole (Prevacid®) Pregnancy: B; Lactation: Unk |
30 mg twice daily for 10 days. |
Food: Take 15-30 minutes before AM and PM meals. |
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and |
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Clarithromycin* (Biaxin®) Pregnancy: C; Lactation: Unk |
500 mg twice daily for 10 days. |
Important side effects: Drug interactions. |
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and |
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Amoxicillin (Amoxil®) Generics available Pregnancy: B; Lactation: Unk |
1,000 mg twice daily for 10 days. |
Food: May take with or without meals. Important side effects: Diarrhea and nausea. May cause nonallergic maculopapular rash.
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Regimen #2 (3 Drugs)
Omeprazole (Prilosec®) Pregnancy: C; Lactation: Unk
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20 mg twice daily for 10 days. |
Food: Take 15-30 minutes before AM and PM meals. |
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And
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Clarithromycin* (Biaxin®) Pregnancy: C; Lactation: Unk
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500 mg twice daily for 10 days. |
Important side effects: Drug interactions. |
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And
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Amoxicillin (Amoxil®) Generics available Pregnancy: B; Lactation: Unk |
1,000 mg twice daily for 10 days. |
Food: May take with or without meals. Important side effects: Diarrhea and nausea. May cause nonallergic maculopapular rash.
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Regimen #3 (4 Drugs)
Omeprazole (Prilosec®) Pregnancy: C; Lactation: Unk |
20 mg PO twice daily for 10 days. |
Food: Take 15-30 minutes before AM and PM meals. |
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And
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Bismuth (Pepto-Bismol®) Pregnancy: C; (D third trimester) Lactation: Unknown |
2 ´ 262 mg tablets PO four times daily for 10 days. |
Important side effects: May darken stools or tongue.
Drug interactions: Salicylates, warfarin. Avoid, or use with caution, in history of aspirin allergy, renal disease, GI bleed. |
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And
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Tetracycline (Sumycin®) Generics available Pregnancy: D; Lactation: Unsafe Caps: 250 mg, 500 mg Tabs: 250 mg, 500 mg |
500 mg PO four times daily for 10 days. |
Food: 1hour before or 2 hours after meals. Do not take with dairy products, antacids, calcium, zinc, or iron products. Take with large glass of water to prevent esophagitis.
Important side effects: GI upset, esophagitis, photosensitivity, discoloration of fingernails. |
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And
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Metronidazole (Flagyl®) Generics available Pregnancy: B; Lactation: Unk Tabs: 250 mg, 500 mg |
500 mg PO three times daily for 10 days. |
Food: Administer on empty stomach unless GI upset occurs, then with food.
Important side effects: Dizziness, headache, confusion, seizures, nausea, metallic taste, insomnia, paresthesias. |
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Caution: May cause disulfiram-like reaction; avoid alcohol.
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