Lansoprazole + Amoxicillin + Clarithromycin: Brands, Price & Uses in Bangladesh

Established Indication

Lansoprazole + Amoxicillin + Clarithromycin is a fixed-combination regimen (a proton pump inhibitor plus two antibiotics) indicated for the treatment of patients with Helicobacter pylori (H. pylori) infection and duodenal ulcer disease (active or a history within the past 5 years), to eradicate H. pylori. Eradication of H. pylori has been shown to reduce the risk of duodenal ulcer recurrence.

Not Indicated For

• Lansoprazole + Amoxicillin + Clarithromycin is not indicated for isolated gastro-oesophageal reflux disease, dyspepsia, or peptic ulcer disease without confirmed H. pylori infection; a full triple-antibiotic course should not be used unless H. pylori infection has actually been demonstrated (by biopsy, stool antigen, or urea breath test).
• Lansoprazole + Amoxicillin + Clarithromycin is not a standard first-line regimen in regions/patients with known high clarithromycin resistance; local resistance patterns should guide the choice of eradication regimen.

Lansoprazole + Amoxicillin + Clarithromycin must always be used as directed by a physician for a confirmed indication; it should not be substituted for other acid-suppressive therapy alone.

Adult Dosage (H. pylori eradication)

All three components of Lansoprazole + Amoxicillin + Clarithromycin are taken together before meals, morning and evening, for the full prescribed duration — typically 14 days, though some protocols use 10 days depending on local resistance patterns and physician judgment.

Renal/Hepatic Adjustment

• Severe renal impairment (creatinine clearance < 30 mL/min): the lansoprazole component of Lansoprazole + Amoxicillin + Clarithromycin is generally reduced to once-daily dosing, and amoxicillin dosing frequency may need reduction; use of Lansoprazole + Amoxicillin + Clarithromycin in severe renal impairment should be individualized by a physician.
• Severe hepatic impairment: clarithromycin exposure increases; use of Lansoprazole + Amoxicillin + Clarithromycin should be reviewed by a physician, with dose reduction or an alternative regimen considered if renal impairment coexists.

Missed Dose

If a dose of Lansoprazole + Amoxicillin + Clarithromycin is missed, it should be taken as soon as remembered unless it is close to the next scheduled dose; doses should not be doubled. Completing every dose for the full course is essential (see Precautions).

Common

• Diarrhea (may be dose-limiting)
• Nausea and abdominal discomfort
• Altered or metallic taste (dysgeusia) — a well-recognized clarithromycin effect
• Headache
• Vaginal candidiasis (yeast infection) due to antibiotic use
• Skin rash

Less Common / Serious

• Clostridioides difficile-associated diarrhea/colitis, which can range from mild to life-threatening and may occur during or up to several weeks after finishing Lansoprazole + Amoxicillin + Clarithromycin.
• Hepatic enzyme elevation or, rarely, hepatotoxicity.
• QT-interval prolongation and, rarely, serious ventricular arrhythmia.
• Severe hypersensitivity reactions, including anaphylaxis and severe cutaneous reactions (e.g., Stevens-Johnson syndrome) — rare but require immediate discontinuation of Lansoprazole + Amoxicillin + Clarithromycin and medical attention.

Patients should seek prompt medical attention for severe or persistent diarrhea, signs of allergic reaction, jaundice, or palpitations while taking Lansoprazole + Amoxicillin + Clarithromycin.