Klacid Hp Special Precautions

Klacid: Clarithromycin is principally excreted by the liver and kidney. Caution should be exercised in administering this antibiotic to patients with impaired hepatic or renal function. Prolonged or repeated use of clarithromycin may result in an overgrowth of nonsusceptible bacteria or fungi. If superinfection occurs, clarithromycin should be discontinued and appropriate therapy instituted. H. pylori organisms may develop resistance to clarithromycin in a small number of patients.
Controloc: Prior to treatment, the possibility of malignancy of gastric ulcer or malignant disease of the esophagus should be excluded as the treatment with pantoprazole may alleviate the symptoms of malignant ulcers and can thus delay diagnosis. To date there has been no experience with treatment in children.
Ospamox: Patients should be told about the potential occurrence of allergic reactions and instructed to report them. If allergic reactions occur, amoxicillin should be discontinued and the usual treatment with epinephrine, antihistamines and corticosteroids should be instituted. If maculopapular amoxicillin rashes develop, treatment should be confined to life-threatening conditions and patients should be carefully monitored. Adequate fluid intake and urine output are essential during treatment. Severe and persistent diarrhea should prompt suspicion of antibiotic-induced pseudomembranous colitis (blood-streaked, mucoid, watery diarrhea; dull diffuse or colicky abdominal pain, fever and occasional tenesmus) which may be life threatening. In pertinent cases, Ospamox should immediately be withdrawn and treatment specific for the offending organism (eg, oral vancomycin) should be instituted. Antiperistaltic drugs are contraindicated.
Use in pregnancy & lactation: Klacid: The safety of clarithromycin during pregnancy and breastfeeding of infants has not been established. Klacid should thus not be used during pregnancy or lactation unless the benefit is considered to outweigh the risk. Some animal studies have suggested an embryotoxic effect, but only at dose levels which are clearly toxic to mothers. Clarithromycin has been found in the milk of lactating animals and in human breast milk.
Controloc: Clinical experience in pregnant women is limited. There is no information on the excretion of pantoprazole into human breast milk. Controloc tablets should only be used when the benefit to the mother is considered greater than the potential risk to the fetus/baby.
Ospamox: There is no current evidence to suggest any embryotoxic, teratogenic or mutagenic effects of Ospamox during pregnancy. It should, however, be borne in mind that amoxicillin diffuses into breast milk.