(amoxicillin · DailyMed)
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LANSOPRAZOLE CLARITHROMYCIN AMOXICILLIN
What it does
Amoxicillin is an antibiotic used to treat infections caused by bacteria.
Commonly used for: infections of the ear, nose, and throat, urinary tract infections, pneumonia, skin infections
Read more in plain English ↓Plain-language summary for general understanding - not medical advice. Always follow your pharmacist/doctor.
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Answers come only from this medicine's registration record, BNF monograph and interaction data - not medical advice.
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Source: Pharmacy and Poisons Board · fetched 2026-01-28 20:59:38 · updated 2026-07-26 13:41:52
Drug Interactions
219Pharmacodynamic Warnings
Clarithromycin appears in TABLE 9: Drugs that prolong the QT interval
Severe (36)
Acalabrutinib - increases exposure
Clarithromycin is predicted to increase the exposure to acalabrutinib. Avoid.
Alprazolam - increases exposure
Clarithromycin moderately increases the exposure to benzodiazepines (alprazolam). Avoid.
Antihistamines,non-Sedating - increases exposure
Clarithromycin is predicted to increase the exposure to antihistamines, non-sedating (mizolastine). Avoid.
Avapritinib - increases exposure
Clarithromycin is predicted to increase the exposure to avapritinib. Avoid.
Benzodiazepines - increases exposure
Clarithromycin moderately increases the exposure to benzodiazepines (alprazolam). Avoid.
Moderate (50)
Alfentanil - increases exposure
Clarithromycin is predicted to increase the exposure to opioids (alfentanil, buprenorphine, fentanyl, oxycodone). Monitor and adjust dose.
Aminophylline - increases exposure
Clarithromycin is predicted to increase the exposure to aminophylline. Adjust dose.
Amlodipine - increases exposure
Clarithromycin is predicted to increase the exposure to calcium channel blockers (amlodipine, felodipine, lacidipine, nicardipine, nifedipine, nimodipine). Monitor and adjust dose.
Antiarrhythmics - increases exposure
Clarithromycin is predicted to increase the exposure to antiarrhythmics (propafenone). Monitor and adjust dose.
Anticholinesterases, Centrally Acting - increases exposure
Clarithromycin is predicted to increase the exposure to anticholinesterases, centrally acting (galantamine). Monitor and adjust dose.
Unknown (133)
Abemaciclib - increases exposure
Clarithromycin is predicted to increase the exposure to abemaciclib. Avoid or adjust abemaciclib dose, p. 1056.
Afatinib - increases exposure
Macrolides are predicted to increase the exposure to afatinib.
Alitretinoin - increases exposure
Clarithromycin is predicted to increase the exposure to retinoids (alitretinoin). Adjust alitretinoin dose, p. 1382.
Almotriptan - increases exposure
Clarithromycin increases the exposure to triptans (almotriptan).
Alphablockers - increases exposure
Clarithromycin is predicted to increase the exposure to alpha blockers (doxazosin).
Data from BNF 85 (British National Formulary). This is not a substitute for professional medical advice. Matched via: exact
About amoxicillin
Amoxicillin is an antibiotic used to treat infections caused by bacteria.
What it treats
- infections of the ear, nose, and throat
- urinary tract infections
- pneumonia
- skin infections
How it works
It kills bacteria or stops their growth, helping to clear up infections.
Who it's for
Amoxicillin is suitable for adults and children who have bacterial infections.
Drug class
Penicillins
AI-assisted summary grounded in BNF data - general information only, not medical advice. Always confirm with your pharmacist or doctor.
About clarithromycin
Clarithromycin is an antibiotic used to treat infections caused by bacteria.
What it treats
- bacterial infections
- chest infections (pneumonia)
- skin infections
- ear infections (otitis media)
How it works
It works by stopping the growth of bacteria, helping your body to fight off the infection.
Who it's for
It is for adults and children with certain bacterial infections.
Drug class
Macrolides
Cautions
- • Be cautious if you are taking other medications that affect heart rhythm.
AI-assisted summary grounded in BNF data - general information only, not medical advice. Always confirm with your pharmacist or doctor.
About lansoprazole
Lansoprazole is a medication that reduces stomach acid, helping to treat certain digestive issues.
What it treats
- acid reflux (gastroesophageal reflux disease)
- stomach ulcers (peptic ulcers)
- Zollinger-Ellison syndrome
How it works
It works by blocking the production of stomach acid, which helps heal and prevent damage to the stomach and esophagus.
Who it's for
It is for adults and children over the age of 1 who need relief from acid-related conditions.
AI-assisted summary grounded in BNF data - general information only, not medical advice. Always confirm with your pharmacist or doctor.
Clinical monograph: Lansoprazole
BNF-referencedLansoprazole is a proton pump inhibitor (PPI) used primarily to treat gastric acid-related disorders such as gastro-oesophageal reflux disease, duodenal ulcers, and gastric ulcers. It functions by irreversibly inhibiting the H+,K+-ATPase enzyme in the gastric parietal cells, which is responsible for the final step in gastric acid secretion, thereby reducing gastric acidity and promoting healing of the gastrointestinal mucosa.
Indications
- Gastro-oesophageal reflux disease
- Duodenal ulcer
- Benign gastric ulcer
- NSAID-associated gastric or duodenal ulcer
- Zollinger-Ellison syndrome
Dosage
Adults: 30 mg once daily for 4 weeks for duodenal ulcers, 30 mg once daily for 8 weeks for gastric ulcers, and 15 mg once daily for maintenance treatment. For gastro-oesophageal reflux disease, the usual dose is 15 mg
Mechanism of action
Lansoprazole is a prodrug that becomes activated in an acidic environment. Once protonated, it forms stable disulfide bonds with cysteine residues on the H+,K+-ATPase enzyme in parietal cells. This covalent binding leads to prolonged inhibition of gastric acid secretion, affecting both basal and stimulated acid production regardless of the stimulus.
Pharmacodynamics
Lansoprazole decreases gastric acid secretion by specifically targeting the H+,K+-ATPase enzyme, which catalyzes the final step in gastric acid secretion. It effectively heals duodenal ulcers and alleviates symptoms associated with acid secretion, such as heartburn, while also reducing pepsin secretion. Its action is effective in both daytime and nocturnal acid secretion, making it useful in treating various acid-related disorders.
Pharmacokinetics
Lansoprazole is absorbed after oral administration, with peak plasma concentrations usually occurring within 1-2 hours. It is extensively metabolized in the liver primarily via cytochrome P450 enzymes, leading to various metabolites that are excreted in urine. The half-life of lansoprazole is approximately 1.5 hours, but its acid-suppressive effects last longer due to its mechanism of action. The presence of food can affect the absorption rate, so it is typically recommended to take lansoprazole before meals.
Contra-indications
- Hypersensitivity to lansoprazole or any of its excipients
- Concurrent use with rilpivirine-containing products
Adverse effects
- Headache
- Diarrhoea
- Nausea
- Abdominal pain
- Constipation
- Flatulence
- Dizziness
- Fatigue
- Skin rash
- Elevated liver enzymes
- Acute interstitial nephritis
- Clostridium difficile-associated diarrhoea
- Bone fractures
- Hypomagnesemia
Interactions
- Increased risk of gastrointestinal infections due to reduced gastric acidity
- Apalutamide may decrease exposure when used with lansoprazole
- May alter the absorption of drugs that require an acidic environment for optimal absorption
Precautions
- Use with caution in patients with hepatic impairment
- Monitor for signs of Clostridium difficile infection in patients with prolonged therapy
- Consider risk of hypomagnesemia and associated complications
Pregnancy
Manufacturer advises to avoid use during pregnancy due to lack of adequate human data.
Breast-feeding
Specialist sources indicate use with caution, as lansoprazole is likely to be present in human milk, but in small amounts probably too low to be harmful.
Storage
Store below 25°C in a dry place, protect from light.
Formulations
- Gastro-resistant capsules
- Oral suspension
- Gastro-resistant tablets
- Gastro-resistant granules
AI-synthesized from BNF references - general information only, not a substitute for professional medical advice or the current BNF. Verify doses with a pharmacist.
Clinical monograph: Amoxicillin
BNF-referencedAmoxicillin is a broad-spectrum antibiotic belonging to the penicillin class, effective against a variety of bacterial infections. It is commonly used to treat conditions such as urinary tract infections, sinusitis, community-acquired pneumonia, and salmonellosis.
Indications
- Bacterial infections
- Urinary tract infections
- Sinusitis
- Uncomplicated community-acquired pneumonia
- Salmonellosis
- Oral infections
- Lyme disease (under expert supervision)
- Acute exacerbation of bronchiectasis
- Anthrax (treatment and post-exposure prophylaxis)
Dosage
Children: 1 month–11 years: 30 mg/kg 3 times a day for 21 days; children 1–4 years: 250 mg 3 times a day; children 5–11 years: 500 mg 3 times a day.
Adults: 500 mg 3 times a day; increased if necessary up to 1 g 3 times a day in severe infections.
Mechanism of action
Amoxicillin works by inhibiting bacterial cell wall synthesis, leading to cell lysis and death. It binds to penicillin-binding proteins (PBPs) located inside the bacterial cell wall, interfering with the transpeptidation process necessary for cell wall integrity.
Pharmacodynamics
Amoxicillin exhibits bactericidal activity against susceptible bacteria. Its action is time-dependent, meaning that its effectiveness is related to the duration of time that the drug concentration remains above the minimum inhibitory concentration (MIC) for the target pathogen.
Pharmacokinetics
Amoxicillin is well absorbed from the gastrointestinal tract, with peak plasma concentrations achieved within 1-2 hours after oral administration. It is widely distributed in body tissues and fluids, and it is excreted primarily via the kidneys. The elimination half-life is approximately 1 hour, and renal impairment may necessitate dosage adjustments.
Adverse effects
- Skin rash
- Gastrointestinal disturbances (nausea, vomiting, diarrhea)
- Allergic reactions (including anaphylaxis)
- Superinfection (due to resistant organisms)
Interactions
- Allopurinol (increases risk of skin rash)
Precautions
- History of penicillin allergy
- Renal impairment (reduce dose)
- Use with caution in patients with mononucleosis
Pregnancy
Use only if clearly needed; no adequate studies in pregnant women.
Breast-feeding
Amoxicillin is excreted in breast milk; use with caution.
Storage
Store in a cool, dry place away from direct sunlight.
Formulations
- Phenoxymethylpenicillin 250mg/5ml oral solution
- Phenoxymethylpenicillin 250 mg tablets
AI-synthesized from BNF references - general information only, not a substitute for professional medical advice or the current BNF. Verify doses with a pharmacist.
Clinical monograph: Clarithromycin
BNF-referencedClarithromycin is a macrolide antibiotic effective against a range of bacterial infections. It is primarily used in the treatment of community-acquired pneumonia, skin infections, and as a prophylactic measure for certain infections. Clarithromycin works by inhibiting bacterial protein synthesis, making it a crucial agent in combating gram-positive and some gram-negative bacteria.
Indications
- Bacterial infections
- Community-acquired pneumonia
- Skin infections
- Prophylaxis for certain infections
Dosage
Adults: 500 mg once daily for
Mechanism of action
Clarithromycin is metabolized to 14-OH clarithromycin, which is active. It penetrates bacterial cell walls and reversibly binds to domain V of the 23S ribosomal RNA of the 50S ribosomal subunit, blocking the translocation of aminoacyl-tRNA and inhibiting polypeptide synthesis. It may be bactericidal in high concentrations against susceptible organisms, particularly Streptococcus pyogenes, S. pneumoniae, Haemophilus influenzae, and Chlamydia trachomatis. Additionally, clarithromycin inhibits the hepatic microsomal CYP3A4 isoenzyme and P-glycoprotein.
Pharmacodynamics
Clarithromycin exhibits a broad spectrum of activity against numerous gram-positive bacteria, including Staphylococcus aureus, Streptococcus pneumoniae, and Streptococcus pyogenes. It also shows activity against gram-negative bacteria such as Haemophilus influenzae and Moraxella catarrhalis, as well as against various anaerobic bacteria, mycobacteria, and other organisms like Mycoplasma, Ureaplasma, and Chlamydia. While typically bacteriostatic, it can sometimes demonstrate bactericidal properties depending on the concentration and the organism.
Pharmacokinetics
Clarithromycin is well absorbed after oral administration, with its bioavailability enhanced by food. It is extensively metabolized in the liver, primarily via CYP3A4, leading to active metabolites. The drug has a half-life of approximately 3 to 4 hours, but its active metabolite, 14-OH clarithromycin, has a longer half-life, contributing to its prolonged activity. Renal impairment can significantly affect its clearance, necessitating dosage adjustments in patients with reduced renal function.
Adverse effects
- Nausea
- Diarrhea
- Abdominal pain
- Dysgeusia
- Headache
- Rash
- Liver enzyme elevations
- QT prolongation
Interactions
- Clarithromycin + acalabrutinib: Severe (increases exposure)
- Clarithromycin + antiarrhythmics: Severe (increases exposure)
- Clarithromycin + dronedarone: Severe (increases exposure)
- Clarithromycin + non-sedating antihistamines: Severe (increases exposure)
- Clarithromycin + mizolastine: Severe (increases exposure)
- Clarithromycin + lurasidone: Severe (increases exposure)
- Clarithromycin + quetiapine: Severe (increases exposure)
- Clarithromycin + avapritinib: Severe (increases exposure)
- Clarithromycin + benzodiazepines: Severe (increases exposure)
- Clarithromycin + alprazolam: Severe (increases exposure)
Precautions
- Caution in hepatic impairment
- Use with caution in renal impairment
- Monitor for signs of QT prolongation
- Consider alternative therapy in patients with history of arrhythmias
- Use with caution in patients with myasthenia gravis due to potential exacerbation
Pregnancy
Manufacturers advise use only if adequate alternatives are not available.
Breast-feeding
Present in milk; use only if no suitable alternatives.
Storage
Store in a cool, dry place away from light. Keep out of reach of children.
Formulations
- Oral suspension 200 mg/5 mL
- Capsules 250 mg
AI-synthesized from BNF references - general information only, not a substitute for professional medical advice or the current BNF. Verify doses with a pharmacist.
Molecular reference: Amoxicillin
PubChem CID 33613Molecular formula: C16H19N3O5S
Mechanism of action
Amoxicillin competitively inhibits penicillin-binding protein 1 and other high molecular weight penicillin binding proteins. Penicillin bind proteins are responsible for glycosyltransferase and transpeptidase reactions that lead to cross-linking of D-alanine and D-aspartic acid in bacterial cell walls. Without the action of penicillin binding proteins, bacteria upregulate autolytic enzymes and are unable to build and repair the cell wall, leading to bacteriocidal action. The penicillins and their metabolites are potent immunogens because of their ability to combine with proteins and act as haptens for acute antibody-mediated reactions. The most frequent (about 95 percent) or "major" determinant of penicillin allergy is the penicilloyl determinant produced by opening the beta-lactam ring of the penicillin. This allows linkage of the penicillin to protein at the amide group. "Minor" determinants (less frequent) are the other metabolites formed, including native penicillin and penicilloic acids. /Penicillins/ Amoxicillin is similar to penicillin in its bactericidal action against susceptible bacteria during the stage of active multiplication. It acts through the inhibition of cell wall biosynthesis that leads to the death of the bacteria.
Pharmacodynamics
Amoxicillin competitively inhibit penicillin binding proteins, leading to upregulation of autolytic enzymes and inhibition of cell wall synthesis. Amoxicillin has a long duration of action as it is usually given twice daily. Amoxicillin has a wide therapeutic range as mild overdoses are not associated with significant toxicity. Patients should be counselled regarding the risk of anaphylaxis, _Clostridium difficile_ infections, and bacterial resistance.
Biological pathways
Source: PubChem (NCBI) · pathways from PathBank, Reactome, WikiPathways & PharmGKB.
Molecular reference: Clarithromycin
PubChem CID 84029Molecular formula: C38H69NO13
Mechanism of action
Clarithromycin is first metabolized to 14-OH clarithromycin, which is active and works synergistically with its parent compound. Like other macrolides, it then penetrates bacteria cell wall and reversibly binds to domain V of the 23S ribosomal RNA of the 50S subunit of the bacterial ribosome, blocking translocation of aminoacyl transfer-RNA and polypeptide synthesis. Clarithromycin also inhibits the hepatic microsomal CYP3A4 isoenzyme and P-glycoprotein, an energy-dependent drug efflux pump. Clarithromycin usually is bacteriostatic, although it may be bactericidal in high concentrations or against highly susceptible organisms. Bactericidal activity has been observed against Streptococcus pyogenes, S. pneumoniae, Haemophilus influenzae, and Chlamydia trachomatis. Clarithromycin inhibits protein synthesis in susceptible organisms by penetrating the cell wall and binding to 50S ribosomal subunits, thereby inhibiting translocation of aminoacyl transfer-RNA and inhibiting polypeptide synthesis. The site of action of clarithromycin appears to be the same as that of erythromycin, clindamycin, lincomycin, and chloramphenicol.
Pharmacodynamics
Clarithromycin is a macrolide antibiotic whose spectrum of activity includes many gram-positive (<i>Staphylococcus aureus, S. pneumoniae, and S. pyogenes</i>) and gram-negative aerobic bacteria (<i>Haemophilus influenzae, H. parainfluenzae, and Moraxella catarrhalis</i>), many anaerobic bacteria, some mycobacteria, and some other organisms including <i>Mycoplasma, Ureaplasma, Chlamydia, Toxoplasma</i>, and <i>Borrelia</i>. Other aerobic bacteria that clarithromycin has activity against include <i>C. pneumoniae and M. pneumoniae</i>. Clarithromycin has an in-vitro activity that is similar or greater than that of erythromycin against erythromycin-susceptible organisms. Clarithromycin is usually bacteriostatic, but may be bactericidal depending on the organism and the drug concentration.
Biological pathways
Source: PubChem (NCBI) · pathways from PathBank, Reactome, WikiPathways & PharmGKB.
Molecular reference: Lansoprazole
PubChem CID 3883Molecular formula: C16H14F3N3O2S
Mechanism of action
As a PPI, lansoprazole is a prodrug and requires protonation via an acidic environment to become activated. Once protonated, lansoprazole is able to react with cysteine residues, specifically Cys813 and Cys321, on parietal H+,K+-ATPase resulting in stable disulfides. PPI's in general are able to provide prolonged inhibition of acid secretion due to their ability to bind covalently to their targets. Lansoprazole is a selective and irreversible proton pump inhibitor. In the acidic environment of the gastric parietal cell, lansoprazole is converted to active sulphenamide derivatives that bind to the sulfhydryl group of (H+, K+)-adenosine triphosphatase ((H+,K+)-ATPase), also known as the proton pump (H+,K+)-ATPase catalyzes the final step in the gastric acid secretion pathway. Lansoprazole's inhibition of (H+,K+)-ATPase results in inhibition of both centrally and peripherally mediated gastric acid secretion. The inhibitory effect is dose-related. Lansoprazole inhibits both basal and stimulated gastric acid secretion regardless of the stimulus.
Pharmacodynamics
Lansoprazole decreases gastric acid secretion by targeting H+,K+-ATPase, which is the enzyme that catalyzes the final step in the acid secretion pathway in parietal cells. Conveniently, lansoprazole administered any time of day is able to inhibit both daytime and nocturnal acid secretion. The result is that lansoprazole is effective at healing duodenal ulcers, reduces ulcer-related pain, and offers relief from symptoms of heartburn Lansoprazole also reduces pepsin secretion, making it a useful treatment option for hypersecretory conditions such as Zollinger-Ellison syndrome.
Biological pathways
Source: PubChem (NCBI) · pathways from PathBank, Reactome, WikiPathways & PharmGKB.
This drug in other countries
The same active ingredient registered across other registries we cover - including different brands.
- AC-CLAV 1000 TABLETS (Each film coated tablet contains Amoxicillin and Cluvalanate Potassium 1000mg · Kiux Pharma
- AC-CLAV 625 TABLETS (Each film coated tablet contains Amoxicillin and Clavulanate Potassium 625 · Kiux Pharma
- ACICLAVCARE 1G TABLETS (Each film-coated tablet contains Amoxicillin trihydrate / Potassium clavulanate 1g) · East African Overseas
- ACINET 1.2G INJECTION (Each vial contains Amoxicillin Sodium/Potassium Clavulanate 1g/0.2g · East African Creasteas
- ACINET 228.5MG/5ML DRY SUSPENSION (Each 5ml of reconstituted suspension contains Amoxicillin Trihydrate/Potassium Clavulanate 200mg/28.5mg) · Indchemie Health Specialities
- ACINET 457MG/5ML DRY SUSPENSION (Each 5ml of reconstituted suspension contains Amoxicillin Trihydrate/Potassium Clavulanate 400mg/57mg) · Indchemie Health Specialities