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.
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