Digestive Diseases and Sciences

, Volume 41, Issue 9, pp 1845–1852 | Cite as

Effect of omeprazole on movement of intravenously administered metronidazole into gastric juice and its significance in treatment ofHelicobacter pylori

  • Sander J. Veldhuyzen van Zanten
  • P. Timothy Pollak
  • Harsh Kapoor
  • Pollen K. Yeung
Esophageal, Gastric And Duodenal Disorders


Four healthy,Helicobacter-negative volunteers were studied to determine the effect of omeprazole on the movement of metronidazole across the gastric mucosa into the gastric lumen. Each received a 500-mg intravenous infusion of metronidazole and repeated serum, and gastric juice samples were obtained concomitantly over an 8-hr study via indwelling intravenous catheter and nasogastric tube. The same protocol was repeated following one week of oral omeprazole 20 mg twice daily. Metronidazole concentrations were measured by high-performance liquid chromatography. The results demonstrated that: metronidazole moves rapidly from serum into gastric juice; omeprazole causes a marked reduction in total metronidazole concentrations in gastric juice, completely accounted for by pH-related shifts in the proportion of ionized metronidazole, but does not alter concentrations of nonionized metronidazole, which remain above the MIC level againstH. pylori; and even under conditions where no pH-related drug trapping occurs (pH>4), concentrations of metronidazole were higher in gastric juice than in serum during most of the study, indicating that a special transport mechanism may be operational. The practical implication of this effect of omeprazole in combination therapy with metronidazole remains to be established.

Key words

Helicobacter pylori metronidazole omeprazole antibiotics combined drug interactions 


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Copyright information

© Plenum Publishing Corporation 1996

Authors and Affiliations

  • Sander J. Veldhuyzen van Zanten
    • 1
  • P. Timothy Pollak
    • 1
  • Harsh Kapoor
    • 1
  • Pollen K. Yeung
    • 1
  1. 1.From the Divisions of Gastroenterology and General Medicine, Faculty of Medicine and College of PharmacyDalhousie University, Victoria General HospitalHalifaxCanada

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