Author(s):
Somasundaram Ramachandran, Chandravadivelu Gopi, AR Magesh, Alekkhya Veeramaneni, Venkata Naga Koteswararao Nerella, Magharla Dasaratha Dhanaraju
Email(s):
ramsnetin@yahoo.com , gopi@giet.ac.in , armagesh09@gmail.com , kotibobby66@gmail.com , alekhya.veramaneni@gmail.com , mddhanaraju@yahoo.com.
DOI:
10.52711/0974-360X.2026.00227 
Address:
Somasundaram Ramachandran1, Chandravadivelu Gopi2, AR Magesh3, Alekkhya Veeramaneni4, Venkata Naga Koteswararao Nerella3, Magharla Dasaratha Dhanaraju5
1Department of Pharmacology, GIET School of Pharmacy, Rajamahendravaram - 533296, Andhra Pradesh, India.
2Department of Pharmaceutical Chemistry, GIET School of Pharmacy, Rajamahendravaram - 533296, Andhra Pradesh, India.
3Department of Pharmaceutical Analysis, GIET School of Pharmacy, Rajamahendravaram - 533296, Andhra Pradesh, India.
4Department of Pharmacognosy, GIET School of Pharmacy, Rajamahendravaram - 533296, Andhra Pradesh, India.
5Director, Research Lab, GIET School of Pharmacy, Rajamahendravaram - 533296, Andhra Pradesh, India.
*Corresponding Author
Published In:
Volume - 19,
Issue - 4,
Year - 2026
ABSTRACT:
The combination of Proton Pump Inhibitors and Clarithromycin is widely used to treat Helicobacter pylori-associated gastroduodenal ulcers. However, scientific evidence suggests potential pharmacokinetic interactions between these drugs. This preclinical study investigated the interactions between Rabeprazole/Pantoprazole and Clarithromycin in healthy rabbits and rats. Initially, rabbits were divided into 4 groups and performed a pharmacokinetic study. Furthermore, the anti-ulcer potential was assessed by Rabeprazole/Pantoprazole alone and co-administered with Clarithromycin using Wistar albino rats. The rats were divided into five groups and each group contained 6 animals, receiving water acted as a control (Group I), Rabeprazole (Group II), Pantoprazole (Group III), Rabeprazole with Clarithromycin (Group IV), and Pantoprazole with Clarithromycin(Group V) respectively. This interaction of proton pump inhibitor and Clarithromycin may enhance therapeutic efficacy and significantly increase proton pump inhibitor levels. Our study demonstrates pharmacokinetic interactions between Rabeprazole with Clarithromycin or Pantoprazole with Clarithromycin, which may impact clinical outcomes. These findings suggest beneficial drug interactions in treating Helicobacter pylori-induced ulcers but also warrant cautious consideration of potential adverse effects.
Cite this article:
Somasundaram Ramachandran, Chandravadivelu Gopi, AR Magesh, Alekkhya Veeramaneni, Venkata Naga Koteswararao Nerella, Magharla Dasaratha Dhanaraju. Interactions between Proton Pump Inhibitors and Clarithromycin: A Preclinical Evaluation of Pharmacokinetic Properties and Antiulcer Activity in Healthy Rabbit and Wistar Albino Rats. Research Journal of Pharmacy and Technology. 2026;19(4):1589-4. doi: 10.52711/0974-360X.2026.00227
Cite(Electronic):
Somasundaram Ramachandran, Chandravadivelu Gopi, AR Magesh, Alekkhya Veeramaneni, Venkata Naga Koteswararao Nerella, Magharla Dasaratha Dhanaraju. Interactions between Proton Pump Inhibitors and Clarithromycin: A Preclinical Evaluation of Pharmacokinetic Properties and Antiulcer Activity in Healthy Rabbit and Wistar Albino Rats. Research Journal of Pharmacy and Technology. 2026;19(4):1589-4. doi: 10.52711/0974-360X.2026.00227 Available on: https://rjptonline.org/AbstractView.aspx?PID=2026-19-4-16
REFERENCES:
1. Mahurkar N, Sayeed ul hasan S.M. Synergistic Antiulcer Effect of Melatonin and Esomeprazole Combination in Pylorus Ligation, Ethanol, Aspirin induced Peptic Ulcers. Asian J. Pharm. Res., 2015; 5(1): 10-14. doi: 10.5958/2231-5691.2015.00002.7
2. Meshram N, Ojha M, Singh A, Alexander A, Ajazuddin, Sharma M. Significance of Medicinal Plant used for the Treatment of Peptic Ulcer. Asian J. Pharm. Tech., 2015; 5(1): 32-37. doi: 10.5958/2231-5713.2015.00007.0
3. Shanshal S.A, Noori A.S, Ghazi J.A, Dahham A.T, Saleh A.S.M, Al-Qazaz H.K. Impact of peptic ulcer disease on the quality of life: A Cross Sectional Study. RJPT., 2022; 15(7): 3267-3272. doi: 10.52711/0974-360X.2022.00548
4. Pandey A, Saraswat N, Wal P, Pal R.S, Wal A, Maurya D. A Detailed Review on: Recent Advances, Pathophysiological Studies and Mechanism of Peptic Ulcer. Res. J. Pharmacology and Pharmacodynamics. 2019; 11(4): 165-170. doi: 10.5958/2321-5836.2019.00029.6
5. Prinz C, Kajimura M, Scott D, Helander H, Shin J, Besancon M, Bamberg K, Hersey S, Sachs G. Acid secretion and the H,K ATPase of stomach. Yale J Biol Med. 1992; 65(6): 577-96. PMID: 1341065; PMCID: PMC2589780.
6. Shamburek RD, Schubert ML. Control of gastric acid secretion. Histamine H2-receptor antagonists and H+K(+)-ATPase inhibitors. Gastroenterol Clin North Am. 1992; 21(3): 527-50. PMID: 1355465.
7. Obata Y, Pachnis V. The Effect of Microbiota and the Immune System on the Development and Organization of the Enteric Nervous System. Gastroenterology. 2016; 151(5): 836-844. doi: 10.1053/j.gastro.2016.07.044
8. Chen D, Hagen SJ, Boyce M, Zhao CM. Neuroendocrine mechanism of gastric acid secretion: Historical perspectives and recent developments in physiology and pharmacology. J Neuroendocrinol. 2023; 35(11): e13305. doi: 10.1111/jne.13305
9. Prerana Musale, S. D. Mankar. A Review on Polyherbal Formulation Used in the Treatment of Gastric Acidity. RJPP., 2023; 15(2): 173-8. doi: 10.52711/0975-4385.2023.00027
10. Labenz J. Consequences of Halicobacter pylori cure in ulcer patients. Best Practice and Research Clinical Gastroenterology., 2000; 14(1): 133-145. https://doi.org/10.1053/bega.1999.0064
11. Kinoshita Y, Ishimura N, Ishihara S. Advantages and disadvantages of Long-term proton pump inhibitor use. J Neurogastroenterol Motil 2018; 24(2): 182-196. https://doi.org/10.5056/jnm18001
12. Gambaro C, Bilardi C, Dullbecco P, Iliritano E, Zentillin P, Mansi C, Usai P, Vigneri S, Savarino V. Comparable Helicobacter pylori eradication rates obtained with 4- and 7-day rabeprazole-based triple therapy a preliminary study. Dig Liver Dis., 2003; 35(11): 763-767. https://doi.org/10.1016/S1590-8658(03)00458-4
13. Aydin A, Onder G, Akarca U, Tekin F, Tuncyurek M, Ilter T. Comparision of 1- and 2- week pantoprazole –based triple therapies in clarithromycin-sensitive and resistant cases. Eur J Intern Med., 2007; 18(6): 496-500. https://doi.org/10.1016/j.ejim.2007.02.018
14. Tankovic J, Lamarque D, Lascals C, Soussy CJ, Delchier JC. Clarithromycin resistance of Helicobacter pyrlori has a major impact on the efficacy of the omeprazole-amoxicillin-clarithromycin therapy. Pathol Biol., 2001; 49(7): 528-533. https://doi.org/10.1016/S0369-8114(01)00209-7
15. Wedemeyer R.S, Blume H. Pharmacokinetic drug interaction profiles of proton pump inhibitors: an update. Drug Saf., 2014; 37(4): 201. https://doi.org/10.1007/s40264-014-0144-0.
16. Johnson D.B, Moganthan R, Swarnabala S. Evaluation of Anti Ulcer activity of Calycopteris floribunda Lams leaf extract in wistar rats. RJPPD., 2024; 16(4): 277-2. doi: 10.52711/2321-5836.2024.00048
17. Vijayaraj S, Singh A, Sampathkumar K.P.. Pharmacokinetic Study of Oxime Prodrug of Gliclazide by LC-MS/MS Method in Rabbit Plasma. Asian J. Research Chem., 2015; 8(5): 351-357. doi: 10.5958/0974-4150.2015.00058.9
18. Alumets J., Ekelund M., Håkanson R., Hedenbro J., Rehfeld J.F, F. Sundler, S. Vallgren. Gastric acid response to pylorus ligation in rats: is gastrin or histamine involved? J Physiol., 1982; 323: 145. https://doi.org/10.1113/jphysiol.1982.sp014065
19. L.E. Borella, F. Herr. A new method for measuring gastric acid secretion in unanesthetized rats. Gastroenterol., 1971; 61(3): 345. https://doi.org/10.1016/S0016-5085(19)33532-2
20. O. Ahmed, T. Nedi, E.M. Yimer. Evaluation of anti-gastric ulcer activity of aqueous and 80% methanol leaf extracts of Urtica simensis in rats. Metab Open., 2022; 14: 100172. https://doi.org/10.1016/j.metop.2022.100172