Helicobacter pylori treatment
Helicobacter pylori (H. pylori) is a bacteria that can infect your stomach. It is a common condition that is present in more than half the people in the world.
Most people with a H. pylori infection will never have any signs or symptoms. It appears that some people may be born with more resistance to the harmful effects of H. pylori.
At Clayton Central Pharmacy we can compound a range of options when failure using first line treament occurs.
Your doctor may prescribe one of the following protocols. The items needed to be compounded are indicated in italics
Quinolone-based triple therapy in adults
a protein pump inhibitor twice daily for 7 or 14 days
PLUS
amoxicillin 1 g orally, twice daily for 10 days
PLUS
levofloxacin 250 mg orally, twice daily (or 500 mg orally, once daily) for 10 days
Bismuth-based quadruple therapy in adults
a protein pump inhibitor twice daily for 7 or 14 days
PLUS
colloidal bismuth subcitrate 120 mg orally, 4 times daily on an empty stomach for 7 or 14 days
PLUS
tetracycline 500 mg orally, 4 times daily on an empty stomach for 7 or 14 days
PLUS
metronidazole 400 mg orally, 3 times daily with food for 7 or 14 days
Rifabutin-based triple therapy in adults
a protein pump inhibitor twice daily for 7 or 14 days
PLUS
amoxicillin 1 g orally, twice daily for 10 days
PLUS
rifabutin 150 mg orally, twice daily for 10 days
Rifaximin treatment
Rifaximin is a broad spectrum oral antibiotic with antimicrobial activity against Gram-positive and Gram-negative aerobic and anaerobic bacteria. It is poorly absorbed and thus has a highly favorable safety profile. Rifaximin has been shown to be effective in the treatment of traveler’s diarrhea, functional bloating and irritable bowel syndrome, small bowel bacterial overgrowth and in the prevention of recurrent overt hepatic encephalopathy. In addition, there is emerging evidence for a possible beneficial effect of rifaximin in the treatment of uncomplicated diverticular disease and in the prevention of recurrent diverticulitis.
At Clayton Central Pharmacy we can make rifaximin in the following strengths:
Rifaximin 200mg capsules
Rifaximin 400mg capsules
Rifaximin 500mg capsules
At Clayton Central Pharmacy we can make rifaximin in the following strengths:
Rifaximin 200mg capsules
Rifaximin 400mg capsules
Rifaximin 500mg capsules
Omeprazole Solution
Omeprazole 2mg/ml 100mL solution
Omeprazole is a proton pump inhibitor that has been available for many years. It is sold under the brand name Losec and is also available as a generic. Solutions of omeprazole are not manufactured, mostly because they are not stable for long periods of time and would not travel well through the supply chain. A compounding pharmacy however can make a custom solution and deliver it directly to the patient. For pediatric patients, solutions help increase compliance and improve treatment outcomes. For patients who are not able to take a capsule at all, a liquid form of medication can be essential.
Treatment with proton pump inhibitors is generally safe and well tolerated when dosed appropriately. Pediatric patients are frequently dosed by body weight but this can vary. Omeprazole actually has a shorter half life in children than in adults because of children’s higher metabolic capacity. Side effects of this medication may include nausea, vomiting, diarrhea, and stomach pain. In the majority of cases these side effects are not significant enough for the patient to discontinue treatment. Patients should not be given PPIs long-term, although they are sometimes prescribed indefinitely. Most patients should be prescribed treatment courses that are shorter, with treatment being discontinued when symptoms improve.
Omeprazole is a proton pump inhibitor that has been available for many years. It is sold under the brand name Losec and is also available as a generic. Solutions of omeprazole are not manufactured, mostly because they are not stable for long periods of time and would not travel well through the supply chain. A compounding pharmacy however can make a custom solution and deliver it directly to the patient. For pediatric patients, solutions help increase compliance and improve treatment outcomes. For patients who are not able to take a capsule at all, a liquid form of medication can be essential.
Treatment with proton pump inhibitors is generally safe and well tolerated when dosed appropriately. Pediatric patients are frequently dosed by body weight but this can vary. Omeprazole actually has a shorter half life in children than in adults because of children’s higher metabolic capacity. Side effects of this medication may include nausea, vomiting, diarrhea, and stomach pain. In the majority of cases these side effects are not significant enough for the patient to discontinue treatment. Patients should not be given PPIs long-term, although they are sometimes prescribed indefinitely. Most patients should be prescribed treatment courses that are shorter, with treatment being discontinued when symptoms improve.
ANal Fissure
Chronic anal fissures are known to be linked with a continuous, excessive muscle tone (flexing) and spasm of the internal anal sphincter.
The main ingredients used in the treatment of anal fissures are:
Nifedipine and diltiazem are calcium channel blockers that dilates the blood vessels and increases blood flow to an anal fissure to promote healing. This therapy also reduces pressure in the anal sphincter, which eases the spasms and decreases pain. The dosage is usually a small, pea-sized dot of ointment applied around the anal opening two to three times daily, as well as before and after bowel movements
In most cases a pea-sized amount of this ointment is applied 3 times per day. The medication should be continued for the prescribed course of treatment, even if a reduction in symptoms is noticed sooner. Full treatment can take up to 3 months
Nifedipine and diltiazem are never combined together but can be found in anal fissure topical ointment in the following concentrations:
The main ingredients used in the treatment of anal fissures are:
- Nifedipine
- Diltiazem
Nifedipine and diltiazem are calcium channel blockers that dilates the blood vessels and increases blood flow to an anal fissure to promote healing. This therapy also reduces pressure in the anal sphincter, which eases the spasms and decreases pain. The dosage is usually a small, pea-sized dot of ointment applied around the anal opening two to three times daily, as well as before and after bowel movements
In most cases a pea-sized amount of this ointment is applied 3 times per day. The medication should be continued for the prescribed course of treatment, even if a reduction in symptoms is noticed sooner. Full treatment can take up to 3 months
Nifedipine and diltiazem are never combined together but can be found in anal fissure topical ointment in the following concentrations:
- Nifedipine 0.05%
- Nifedipine 0.1%
- Nifedipine 0.2%
- Nifedipine 0.3%
- Nifedipine 0.4%
- Nifedipine 0.5%
- Diltiazem 2%
- Lidocaine 1% to 5%