Uses

Used as triple therapy for the eradication of Helicobacter pylori infection in patients with peptic ulcer disease or gastritis. Clarithromycin and tinidazole provide dual antibiotic coverage while omeprazole suppresses gastric acid to optimize the antibiotic environment.

Do not use if

Contraindicated in patients with hypersensitivity to macrolides, nitroimidazoles, or benzimidazoles. Avoid concurrent use of ergot alkaloids, pimozide, or drugs that prolong QT interval. Tinidazole: avoid alcohol consumption and use in first trimester of pregnancy.

Side effects

Common side effects include nausea, diarrhea, abdominal discomfort, and metallic taste (tinidazole). Clarithromycin may prolong the QT interval and cause hepatic enzyme elevations. Omeprazole may cause hypomagnesemia and increased risk of C. difficile infection with prolonged use.

Warnings

Risk of QT prolongation with clarithromycin; avoid in patients with known QT prolongation or taking QT-prolonging drugs. Risk of C. difficile-associated diarrhea with the antibiotic components. Alcohol must be avoided with tinidazole. Monitor liver function in patients with hepatic disease.

How it works

Clarithromycin is a macrolide antibiotic inhibiting bacterial protein synthesis via the 50S ribosomal subunit. Tinidazole is a nitroimidazole that generates reactive species damaging H. pylori DNA. Omeprazole is a proton pump inhibitor that irreversibly blocks the H+/K+-ATPase in gastric parietal cells, raising intragastric pH and enhancing antibiotic stability and efficacy.

Storage

Store at room temperature below 30°C, protected from moisture and light.