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document
Pharmacokinetic interaction between proton pump inhibitors and roxithromycin in volunteers . BACKGROUND Triple therapy including two antibiotics and a proton pump inhibitor is a rational approach to the treatment of Helicobacter pylori induced peptic ulcer disease . The interaction of antimicrobial therapy and acid suppression is not yet well elucidated . AIMS To investigate the effects of proton pump inhibitors on roxithromycin levels in plasma and gastric tissue under steady-state conditions in volunteers . METHODS In two crossover studies omeprazole 20 mg b.d. , lansoprazole 30 mg b.d. , roxithromycin 300 mg b.d. , and the combination of roxithromycin with either omeprazole or lansoprazole were administered to 12 healthy volunteers over 6 days . Blood plasma levels of the drugs were measured . In addition , roxithromycin concentrations were also determined in gastric juice and gastric tissue obtained during endoscopy . RESULTS The proton pump inhibitors and roxithromycin did not alter the blood plasma pharmacokinetics of each other . When compared to roxithromycin administered alone , its combination with a proton pump inhibitor significantly increased the roxithromycin concentrations in gastric juice ( 3.0-5.0 microg/mL vs. 0.3-0.4 microg/mL ) and gastric tissue ( antrum : 3.8-4.0 vs. 2.8 microg/g , fundus : 5.9-7.4 vs. 4.2-4.4 microg/g ) . CONCLUSIONS Proton pump inhibitors and roxithromycin do not alter the systemic bioavailability of each other . However , proton pump inhibitors increase the local concentration of roxithromycin in the stomach which may contribute to the clinically proven synergic beneficial action in eradication therapy of H. pylori .
3372
Intervention_Pharmacological
proton pump inhibitors
3373
Intervention_Pharmacological
roxithromycin
3374
Intervention_Pharmacological
proton pump inhibitors
3375
Intervention_Pharmacological
roxithromycin
3376
Intervention_Pharmacological
omeprazole 20 mg b.d.
3377
Intervention_Pharmacological
lansoprazole 30 mg b.d.
3378
Intervention_Pharmacological
roxithromycin 300 mg b.d.
3379
Intervention_Pharmacological
roxithromycin
3380
Intervention_Pharmacological
omeprazole or lansoprazole
3381
Intervention_Pharmacological
proton pump inhibitors
3382
Intervention_Pharmacological
roxithromycin
3383
Intervention_Pharmacological
roxithromycin
3384
Intervention_Pharmacological
Proton pump inhibitors
3385
Intervention_Pharmacological
roxithromycin
3386
Intervention_Pharmacological
proton pump inhibitors
3387
Outcome_Physical
Blood plasma levels
3388
Outcome_Physical
roxithromycin concentrations
3389
Outcome_Physical
blood plasma pharmacokinetics
3390
Outcome_Physical
roxithromycin concentrations in gastric juice
3391
Outcome_Physical
gastric tissue
3392
Outcome_Physical
concentration of roxithromycin
3393
Participant_Condition
volunteers
3394
Participant_Sample-size
12
3395
Participant_Condition
healthy