Interactions between Proton Pump Inhibitors and Clarithromycin: A Preclinical Evaluation of Pharmacokinetic Properties and Antiulcer Activity in Healthy Rabbit and Wistar Albino Rats

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.