PPI in Triple Therapy: Questions about timing

The most popular treatments consist of two antibiotics (one of which is usually clarithromycin) plus a strong acid blocker such as omeprazole (PriLosec, Nexium, Somac, Zoton, etc.). Treatment is for 7-10 days. Cure rate is about 85%

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PPI in Triple Therapy: Questions about timing

Post by eliuri » Mon Feb 25, 2019 5:39 am


I'm about to begin triple therapy for H.Pylori: Amoxicillin, Clarithromycin+ PPI (Omeprazole 40 mg)

As prescribed by Gastroenterologist, the PPI is: Omeprazole one tablet 40 mg once daily for 14 days. One hour before meals

When I asked pharmacist to clarify timing of PPI in relation to antibiotics, she said the PPI must be taken very first thing in the morning, even before morning coffee. At least hour before eating anything or taking any medication. Personally, it would be more convenient for me to take it an hour before evening meal..

She was also surprised the PPI wasnt prescribed for twice a day-- but only once daily. So some divergence here from whats on the prescription

Two questions:

1) Can the PPI simply be taken one hour (or more) before evening meal and evening antibiotics, as the prescription implies?

2) Is one 40 mg capsule Omeprazole- once daily- reasonable as part of triple therapy regime? Or might it have been an error and actually that should have been split in two doses?


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Re: PPI in Triple Therapy: Questions about timing

Post by Helico_expert » Tue Feb 26, 2019 6:52 am

answer 1.
it's about consistency. As long as you take it the same time everyday, then the effective dose is maintained in your body and you'll get the same effect.

answer 2.
20 mg twice a day is better. especially some people has higher metabolic rate. the higher dose you take in the morning is probably half gone in the evening. In addition, you might want to try other PPI instead of omeprazole because of that. We prefer rabeprazole. and we give a higher dose, 20mg three times a day.

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