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Rabeprazole, metronidazole, Clarithromycin, Amoxicillin
This is a quadruple therapy combination that eradicates Helicobacter pylori by suppressing gastric acid and simultaneously attacking the bacteria with three antibiotics.
This is a quadruple therapy combination that eradicates Helicobacter pylori by suppressing gastric acid and simultaneously attacking the bacteria with three antibiotics. Used for Helicobacter pylori eradication in peptic ulcer disease, H. pylori-associated gastritis.
At a glance
| Generic name | Rabeprazole, metronidazole, Clarithromycin, Amoxicillin |
|---|---|
| Also known as | Rabeprazole: Pariet, Metronidazole: Flagyl, Clarithromycin: Klacid, Amoxicillin: Amoxil |
| Sponsor | American University of Beirut Medical Center |
| Drug class | Proton pump inhibitor + antibiotic combination therapy |
| Target | H+ ATPase (rabeprazole); bacterial ribosome and DNA (metronidazole, clarithromycin); bacterial cell wall (amoxicillin) |
| Modality | Small molecule |
| Therapeutic area | Gastroenterology / Infectious Disease |
| Phase | FDA-approved |
Mechanism of action
Rabeprazole is a proton pump inhibitor that reduces gastric acid secretion, creating an environment where the three antibiotics (metronidazole, clarithromycin, and amoxicillin) can effectively penetrate and kill H. pylori. Metronidazole and clarithromycin are bactericidal agents that disrupt bacterial protein synthesis and DNA, while amoxicillin inhibits bacterial cell wall synthesis. The combination approach reduces antibiotic resistance.
Approved indications
- Helicobacter pylori eradication in peptic ulcer disease
- H. pylori-associated gastritis
Common side effects
- Diarrhea
- Nausea
- Abdominal pain
- Headache
- Metallic taste (metronidazole)
- Vomiting
Key clinical trials
- Efficacies of Susceptibility-guided vs Empiric Therapy for Rescue Treatment of Helicobacter Pylori Infection (PHASE4)
- Comparing the Efficacy of Hybrid, High-dose Dual and Bismuth Quadruple Therapies (PHASE3)
- The Observation on the Efficacy of Dual Therapy Based on Vonoprazan in Eradicating Helicobacter Pylori (NA)
- A Real World Study of Bismuth Colloidal Pectin Granules Quadruple Therapy for H. Pylori Eradication (PHASE4)
- Efficacies of Hybrid and High-dose Dual Therapies for the First-line Anti-H Pylori Treatment (NA)
- 14-day PCAB-based High-dose Dual Therapy and14-day PCAB-based Triple Therapy vs 14-day PPI-based Reverse Hybrid Therapy (PHASE4)
- Helicobacter Pylori Eradication and Follow-up (PHASE4)
- Efficacies of Antimicrobial Susceptibility-Guided Versus Empirical Therapy for Rescue Treatment of Helicobacter Pylori Infection (PHASE4)
Primary sources
Every claim on this page is sourced from regulatory or scientific primary sources. See our editorial policy for full methodology.
| Source | Used for |
|---|---|
| ClinicalTrials.gov | Trial enrolment, design, endpoints, results |
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