摘要
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 (t0), 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, t 8 = 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.
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 (t0), 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, t 8 = 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.
