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Overview: Lansoprazole, amoxicillin, and clarithromycin are used together to treat Helicobacter pylori (H. pylori) infections, which occur in the stomach. Common side effects include diarrhea, headache, or change in how things taste. Serious side effects are rare but may include severe diarrhea, skin reactions, or allergic reactions.

Uses

What is lansoprazole, amoxicillin, and clarithromycin used for?

Lansoprazole, amoxicillin, and clarithromycin are commonly used together to treat Helicobacter pylori (H. pylori) infections in people who have or have had certain types of ulcers. Infection with H. pylori can lead to ulcers and other problems.

Lansoprazole, amoxicillin, and clarithromycin are used together to fight a specific type of bacteria that infects the stomach. Some bacteria may have developed resistance to amoxicillin and clarithromycin, which are antibiotics. This may make the antibiotics not work as well. 

These medicines will not work for infections caused by viruses, such as the common cold, the flu, or coronavirus. They also will not work for any other infections that are not caused by bacteria. Taking any antibiotic when it is not needed may cause the antibiotic to not work for bacterial infections in the future.

Lansoprazole, amoxicillin, and clarithromycin may also be used for other conditions as determined by your healthcare provider.

How does lansoprazole, amoxicillin, and clarithromycin work (mechanism of action)?

Helicobacter pylori (H. pylori) is a type of bacteria that grows well in acidic places, like the stomach. Lansoprazole, amoxicillin, and clarithromycin are three different medicines that are used together to help get rid of an H. pylori infection. They each work in different ways. 

Lansoprazole helps to fight H. pylori infection by decreasing the amount of acid that the stomach makes. Amoxicillin is an antibiotic that kills H. pylori by preventing it from being able to create a cell wall. Clarithromycin is an antibiotic that stops H. pylori from making proteins that it needs to grow and multiply. 

How is lansoprazole, amoxicillin, and clarithromycin supplied (dosage forms)?

Brands and other names

  • Prevpac

Dosage forms and strengths

  • Amoxicillin 500 mg oral capsules
  • Clarithromycin 500 mg oral tablets
  • Lansoprazole 30 mg delayed-release oral capsules

How should I store lansoprazole, amoxicillin, and clarithromycin?

Lansoprazole, amoxicillin, and clarithromycin should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). They can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting them. Store in a cool, dry place. Protect from light and moisture.

Side Effects

What are the most common side effects of lansoprazole, amoxicillin, and clarithromycin?

The most common side effects of lansoprazole, amoxicillin, and clarithromycin are listed below. Tell your healthcare provider if you have any of these side effects that bother you.

  • Diarrhea
  • Headache
  • Change in how things taste

There may be other side effects of lansoprazole, amoxicillin, and clarithromycin that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of lansoprazole, amoxicillin, and clarithromycin?

While less common, the most serious side effects of lansoprazole, amoxicillin, and clarithromycin are described below, along with what to do if they happen.

Severe Allergic Reactions. Lansoprazole, amoxicillin, and clarithromycin may cause allergic reactions, including a specific type of allergic reaction called DRESS. DRESS stands for Drug Reaction with Eosinophilia and Systemic Symptoms. It is also sometimes called multiorgan hypersensitivity. This is a reaction that can affect multiple parts of the body, including your liver, kidneys, and heart. Stop taking the medicine and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain
  • Dark colored urine
  • Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Severe Skin Reactions. Amoxicillin and clarithromycin can cause severe skin reactions, called Stevens-Johnson Syndrome (SJS), Toxic Epidermal Necrolysis (TEN), and acute generalized exanthematous pustulosis (AGEP), which can lead to death if not treated. If you develop a rash, stop the medicine and call your healthcare provider right away. Get emergency help if you have any of the following symptoms of SJS, TEN, or AGEP.

  • Painful red or purple skin that looks burned and peels off
  • Red skin covered with fluid-filled bumps (pustules)
  • Flat red rash or blisters on your skin, mouth, nose, and genitals
  • Red, painful, watery eyes

Antibiotic-associated Diarrhea. An overgrowth of germs called Clostridioides difficile, or “C. diff,” can happen in your gut with many types of antibiotics, including amoxicillin and clarithromycin. This can cause a condition known as antibiotic-associated diarrhea and can happen even up to two months after stopping the antibiotic. Call your healthcare provider right away if you have any of the following symptoms of this condition.

  • Watery diarrhea
  • Diarrhea that does not go away
  • Blood in your stool (poop)
  • Severe stomach cramps
  • Fever that starts after you start or finish the medicine

Drug-induced Enterocolitis Syndrome (DIES). Amoxicillin may cause a rare reaction in the gastrointestinal (GI) tract called drug-induced enterocolitis syndrome (DIES). This rare reaction usually occurs within a day of taking the medicine. Stop taking lansoprazole, amoxicillin, and clarithromycin and call your healthcare provider right away if you have any of the following symptoms within 24 hours of taking these medicines.  

  • Severe vomiting that happens within a couple hours of taking the medicine
  • Severe diarrhea
  • Extreme tiredness or weakness
  • Unusually pale skin
  • Low blood pressure
  • Dizziness or lightheadedness
  • Confusion
  • Unsteadiness

Heart Rhythm Changes. Clarithromycin may cause a rare, dangerous heart rhythm problem called QT prolongation and torsade de pointes. Some people have a higher risk of this, including people who are older, have other people in their family who have had these conditions, have low potassium or magnesium levels, or who take other medicines that can prolong the QT interval. Tell your healthcare provider right away if you faint or have changes in your heart rate or rhythm, such as a fast or skipping heartbeat.

Liver Damage. Liver damage, also called hepatotoxicity, can happen when taking clarithromycin. Call your healthcare provider right away if you have any of the following symptoms of liver damage.

  • Nausea or vomiting
  • Stomach or belly pain
  • Fever
  • Weakness or unusual tiredness
  • Itching
  • Loss of appetite
  • Light-colored poop
  • Dark-colored urine (pee)
  • Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Kidney Problems. A type of kidney problem called acute tubulointerstitial nephritis can happen at any time during treatment with lansoprazole. If you notice a decrease in the amount of your urine (pee) or see blood in your urine, call your healthcare provider right away.

Lupus. Some medicines, such as lansoprazole, can cause certain types of lupus or worsen lupus you already have. Lupus is an autoimmune disorder where your immune cells attack other cells or organs in your body. Tell your healthcare provider right away if you have new or worsening joint pain or a rash on your arms or cheeks.

Warnings & Precautions

Who should not use lansoprazole, amoxicillin, and clarithromycin?

Allergies to Ingredients. People who are allergic to any of the following should not take lansoprazole, amoxicillin, and clarithromycin.

  • Amoxicillin
  • Clarithromycin
  • Lansoprazole
  • Prevpac
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific lansoprazole, amoxicillin, and clarithromycin products they stock.

Allergies to Certain Antibiotics. Some people who have an allergy to certain other antibiotics may also be allergic to amoxicillin or clarithromycin. Let your healthcare provider know if you have ever had a severe allergic reaction to an antibiotic.

Drug Interactions. Lansoprazole, amoxicillin, and clarithromycin should not be taken while you are using certain other medicines. Before taking lansoprazole, amoxicillin, and clarithromycin, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Heart Rhythm Changes. Clarithromycin may cause a rare, dangerous heart rhythm problem called QT prolongation and torsade de pointes. If you have ever had either of these conditions, you should not take clarithromycin. 

Liver Damage from Clarithromycin. In rare cases, clarithromycin can cause liver damage. If this has happened to you in the past, you should not take clarithromycin again.

What should I know about lansoprazole, amoxicillin, and clarithromycin before using it?

Do not take lansoprazole, amoxicillin, and clarithromycin unless it has been prescribed to you by a healthcare provider. Take it as prescribed. 

Do not share lansoprazole, amoxicillin, and clarithromycin with other people, even if they have the same condition as you. It may harm them.

Keep lansoprazole, amoxicillin, and clarithromycin out of the reach of children.

Each dose of lansoprazole, amoxicillin, and clarithromycin is provided in a “daily administration card.” Follow the instructions on the card. All three medicines should be taken together twice every day before a meal, in the morning and the evening. At the end of each day after all doses have been taken, the empty card may be thrown away.

People who are under one year of age or over the age of 65 can be at greater risk for some side effects from lansoprazole, amoxicillin, and clarithromycin. Talk to your healthcare provider about the risks if you or your child are in either of these age groups.

Clarithromycin can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how the medicine affects you.

What should I tell my healthcare provider before using lansoprazole, amoxicillin, and clarithromycin?

Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if lansoprazole, amoxicillin, and clarithromycin is right for you.

In particular, make sure that you discuss any of the following.

Heart Rhythm Problems. Tell your healthcare provider if you or anyone in your family has a history of heart attack or an irregular heartbeat (arrhythmia), especially a condition called “QT prolongation” or “long QT syndrome.”

Myasthenia Gravis. Clarithromycin may worsen a condition called myasthenia gravis. Tell your healthcare provider if you have this condition. 

Other Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.

Pregnancy. Clarithromycin may cause harm to an unborn baby. It is not known if or how amoxicillin or lansoprazole could affect pregnancy or harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant. If you become pregnant, contact your healthcare provider right away. 

Breastfeeding. Lansoprazole, amoxicillin, and clarithromycin pass into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should take lansoprazole, amoxicillin, and clarithromycin while breastfeeding.

Interactions

Does lansoprazole, amoxicillin, and clarithromycin interact with foods or drinks?

Lansoprazole, amoxicillin, and clarithromycin should be taken together before a meal, twice every day.

It is unknown if drinking alcohol will affect lansoprazole, amoxicillin, and clarithromycin, but heavy drinking can make it harder for your body to fight infection and increase your risk of developing stomach ulcers.

Does lansoprazole, amoxicillin, and clarithromycin interact with other medicines (drug interactions)?

Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before taking lansoprazole, amoxicillin, and clarithromycin.

  • A benzodiazepine, such as clonazepam (Klonopin), diazepam (Valium and others), or lorazepam (Ativan and others), which is a medicine used for anxiety, muscle spasms, or seizures
  • A birth control pill
  • A blood thinner, which is a medicine used to treat or prevent blood clots
  • A medicine for diabetes
  • A medicine used to control your heart rate or rhythm (antiarrhythmic)
  • A statin, such as atorvastatin (Lipitor and others) or rosuvastatin (Crestor), which is a medicine to lower cholesterol
  • An ergot, such as ergotamine (Ergomar) or dihydroergotamine (Migranal or Trudhesa), which is a medicine used to treat migraine
  • Allopurinol, colchicine, or probenecid, which is a medicine commonly used for gout
  • A medicine for HIV or AIDS
  • Digoxin (Lanoxin), which is a medicine used to treat irregular heartbeat and some types of heart failure
  • Lomitapide (Juxtapid, Lojuxta), which is a medicine to lower cholesterol
  • Quetiapine (Seroquel) or lurasidone (Latuda), which is a medicine used to treat certain mental health problems
  • Medicines that can cause QT prolongation, which is a potentially dangerous heart rhythm problem
  • Methotrexate (Trexall and others)
  • Pimozide, which is a medicine for Tourette syndrome
  • Theophylline (Theo-24, Elixophyllin), which is a medicine for asthma or certain other breathing problems
  • Tacrolimus, which is commonly used to prevent organ transplant rejection
  • St. John’s wort, which is a supplement that may be used to treat depression
  • Rifampin (Rifadin), which is a medicine commonly used to treat an infection called tuberculosis

Many other medicines may alter the blood levels of lansoprazole, amoxicillin, and clarithromycin, and vice versa. Tell your healthcare provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with lansoprazole, amoxicillin, and clarithromycin. Always check with your healthcare provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much lansoprazole, amoxicillin, and clarithromycin?

If you or someone else has used too much lansoprazole, amoxicillin, and clarithromycin, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of lansoprazole, amoxicillin, and clarithromycin?

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses.

It is important to complete your prescribed course of lansoprazole, amoxicillin, and clarithromycin, even if your symptoms get better or go away. This will reduce the risk that future infections are resistant to these or other similar medicines.

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