MACROLIDES AND PROTON PUMP INHIBITORS

Clarithromycin almost doubles the serum levels of esomeprazole, lansoprazole and omeprazole. A small rise in the serum levels of clarithromycin also occurs, which may be therapeutically useful. Some very limited evidence indicates that erythromycin causes a larger rise in serum omeprazole levels, without improving its gastric acid lowering effect.
Given the wide use of Helicobacter pylori eradication regimens containing these drugs it seems unlikely that this interaction is detrimental.