Influence of 1-week Helicobacter pylori eradication therapy with rabeprazole, clarithromycin, and metronidazole on 13C-aminopyrine breath test

Dig Dis Sci. 2005 Jul;50(7):1207-13. doi: 10.1007/s10620-005-2761-z.

Abstract

Helicobacter pylori eradication therapy is commonly prescribed in the general population. Treatment consists of drugs that are mainly metabolized by the liver cytochrome P-450 (CYP) enzymatic pool. Most H. pylori-infected patients often take drugs for comorbid illnesses, therefore increasing the potential for drug-drug interactions. We aimed to evaluate the interactions of rabeprazole, clarithromycin, and metronidazole 1-week H. pylori eradication therapy with CYP-dependent liver metabolic function in clinical practice. Ten patients referred to our unit for H. pylori infection underwent 1-week eradication therapy with rabeprazole (20 mg, b.i.d.), clarithromycin (500 mg, b.i.d.), and metronidazole (500 mg, b.i.d.). We chose the 13C-aminopyrine breath test (13C-ABT) to evaluate CYP-dependent liver function since it is noninvasive and nonharmful. All patients underwent 13C-ABT at three time points: before therapy (to), at the end of therapy (t8), and after 1 month of follow-up (t38). Mean 13C-ABT dose/hr (t0 = 14.0 +/- 5.4, t8 = 13.5 +/- 4.0, t38 = 16.1 +/- 5.6) as well as 13C-ABT cumulative dose (t0 = 2.4 +/- 1.1, t8 = 2.4 +/- 0.8, t38 = 2.6 +/- 1.0) were not statistically different at the three time points of the study. These results did not seem to be influenced by drugs being administered concomitantly. In everyday clinical practice rabeprazole-based H. pylori eradication therapy does not seem to display any significant interactions with CYP-dependent liver function, even in patients on multiple drugs.

Publication types

  • Clinical Trial

MeSH terms

  • 2-Pyridinylmethylsulfinylbenzimidazoles
  • Aged
  • Aminopyrine
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / therapeutic use
  • Anti-Infective Agents / administration & dosage*
  • Anti-Infective Agents / therapeutic use
  • Benzimidazoles / administration & dosage*
  • Benzimidazoles / therapeutic use
  • Breath Tests
  • Carbon Isotopes
  • Clarithromycin / administration & dosage*
  • Clarithromycin / therapeutic use
  • Cytochrome P-450 Enzyme System / metabolism
  • Drug Interactions
  • Drug Therapy, Combination
  • Enzyme Inhibitors / administration & dosage*
  • Enzyme Inhibitors / therapeutic use
  • Female
  • Helicobacter Infections / drug therapy*
  • Helicobacter Infections / physiopathology
  • Helicobacter pylori*
  • Humans
  • Liver / enzymology
  • Liver Function Tests
  • Male
  • Metronidazole / administration & dosage*
  • Metronidazole / therapeutic use
  • Middle Aged
  • Omeprazole / administration & dosage*
  • Omeprazole / analogs & derivatives*
  • Omeprazole / therapeutic use
  • Rabeprazole

Substances

  • 2-Pyridinylmethylsulfinylbenzimidazoles
  • Anti-Bacterial Agents
  • Anti-Infective Agents
  • Benzimidazoles
  • Carbon Isotopes
  • Enzyme Inhibitors
  • Aminopyrine
  • Metronidazole
  • Rabeprazole
  • Cytochrome P-450 Enzyme System
  • Clarithromycin
  • Omeprazole