Nexpro HP Combipack belongs to Antacids used to treat peptic ulcer disease caused by Helicobacter pylori infection. Helicobacter pylori are a type of bacteria that infects the stomach and lead to excess acid production. This effect leads to the formation of sores or ulcers in the stomach lining, which is called peptic ulcer disease. Symptoms include stomach pain or discomfort, loss of appetite, weight loss, difficulty swallowing, bloating, nausea, and vomiting.  

Nexpro HP Combipack is a combination medicine that contains Clarithromycin, Esomeprazole, and Amoxicillin. Clarithromycin is an antibiotic that kills the bacteria (Helicobacter pylori), causing the infection. Esomeprazole is a proton pump inhibitor and acts by reducing the production of stomach acid. Amoxicillin is a penicillin antibiotic and bactericidal (kills the bacteria). It works by preventing the formation of bacterial cell covering (protective cell wall) necessary for their survival. Together, Nexpro HP Combipack helps to treat peptic ulcer disease effectively.

Nexpro HP Combipack is available in the form of tablets. You should take this medicine exactly as prescribed by your doctor. Nexpro HP Combipack may cause side effects such as headache, diarrhoea, stomach pain, constipation, flatulence, nausea (feeling sick), vomiting (being sick), skin rash, difficulty sleeping, changes in the sense of taste, indigestion, excessive sweating. These side effects usually resolve without any medical attention. However, if any of these side effects persist or worsen, consult your doctor immediately.

Do not take Nexpro HP Combipack if you are allergic to Esomeprazole, Clarithromycin, Amoxicillin, other antibiotics (especially penicillin), other proton pump inhibitors (pantoprazole, lansoprazole, or omeprazole, etc.), or any other contents of it. Before taking Nexpro HP Combipack, inform your doctor if you have arrhythmias (a condition with irregular heartbeat), hypokalemia (low potassium levels in the blood), severe liver failure, severe kidney problems, heart problems, urination problems, glandular fever (fever, sore throat, swollen glands, and extreme tiredness), lymphatic leukaemia (a type of blood cancer), HIV, and undergoing a blood test for chromogranin A levels (for cancers associated with endocrine (hormonal) and nervous system). Also, inform your doctor if you are pregnant or breastfeeding. Nexpro HP Combipack should be used with caution in children and may require dose adjustments. Older people may not require any dose adjustments while using Nexpro HP Combipack. Do not take alcohol, as it may worsen the side effects. Nexpro HP Combipack may cause dizziness in some patients, so do not drive or operate heavy machinery if you feel dizzy.

Nexpro HP Combipack is a combination medicine that contains Clarithromycin, Esomeprazole, and Amoxicillin. Clarithromycin is an antibiotic that kills bacteria (Helicobacter pylori) causing the infection. Esomeprazole is a proton pump inhibitor (responsible for acid production) and acts by reducing stomach acid production. This effect helps to reduce symptoms of peptic ulcer disease. Amoxicillin is a penicillin antibiotic and bactericidal (kills the bacteria). It works by preventing the formation of bacterial cell covering (protective cell wall) necessary for their survival. Together, Nexpro HP Combipack is used to treat the infection and peptic ulcer disease.

• Stomach pain
• Constipation
• Flatulence
• Nausea (feeling sick)
• Vomiting (being sick)
• Skin rash
• Difficulty sleeping
• Changes in the sense of taste
• Indigestion
• Excessive sweating
• Headache
• Diarrhoea

Nexpro HP Combipack should not be used in patients with arrhythmias or taking antiarrhythmic agents, as it may lead to prolonged QT intervals, which can be life-threatening. While using Nexpro HP Combipack, if you notice severe or prolonged diarrhoea, vomiting food or blood, black stools, unexplained weight loss, or symptoms of liver disease (jaundice (yellowing of the skin), loss of appetite, dark urine, or itching), stop the medication and consult a doctor immediately. Besides, if you notice skin rashes or lesions, especially on sun-exposed skin, stop the treatment and immediately consult a doctor. Nexpro HP Combipack increases the risk of Clostridium difficile-associated diarrhoea (inflammation of the large intestine due to Clostridium infection). Nexpro HP Combipack may increase the risk of fractures, cause liver impairment, and impair the absorption of vitamin B12 in the body when used for prolonged periods.

Drug-Drug Interactions: Nexpro HP Combipack may interact with anti-gout medications (allopurinol, colchicine, and probenecid), anticoagulants (warfarin, clopidogrel), medicines used to treat diabetes (nateglinide, repaglinide, and insulin), anticancer medication (methotrexate, vinblastine, and erlotinib), antibiotics (tetracycline), anti-HIV medication (atazanavir), antidepressants (citalopram, imipramine, clomipramine, and hypericum perforatum), medication to treat fits (phenytoin, carbamazepine, and valproate), antianxiety medication (diazepam), a steroid medicine (methylprednisolone), a medicine used to treat heart problems (digoxin, verapamil, quinidine, and disopyramide), immunosuppressant (cyclosporine, sirolimus, and tacrolimus), a medicine used to treat tuberculosis (rifampicin), a medicine to treat heartburn (cisapride), a medicine used to widen blood vessels (cilostazol), antiallergic (astemizole and terfenadine), antipsychotic (pimozide and quetiapine), medicines used to treat migraine (ergotamine and dihydroergotamine), lipid-lowering drugs (lovastatin and simvastatin), and sedatives (alprazolam, triazolam, and midazolam).

Drug-Food Interactions: No interactions found.

Drug-Disease Interactions: Nexpro HP Combipack should be used with caution in patients with arrhythmias (a condition with irregular heartbeat), vitamin B12 deficiency, hypokalemia (low potassium levels in the blood), severe liver failure, severe kidney problems, heart problems, urination problems, glandular fever (fever, sore throat, swollen glands, and extreme tiredness), lymphatic leukaemia (a type of blood cancer), and HIV.

• ALLOPURINOL
• COLCHICINE
• PROBENECID
• WARFARIN
• CLOPIDOGREL
• NATEGLINIDE
• REPAGLINIDE
• INSULIN
• METHOTREXATE
• ERLOTINIB
• TETRACYCLINE
• ATAZANAVIR
• IMIPRAMINE
• CLOMIPRAMINE
• HYPERICUM PERFORATUM
• PHENYTOIN
• CARBAMAZEPINE
• VALPROATE
• DIAZEPAM
• METHYLPREDNISOLONE
• DIGOXIN
• VERAPAMIL
• QUINIDINE
• DISOPYRAMIDE
• CYCLOSPORINE
• TACROLIMUS
• SIROLIMUS
• RIFAMPICIN
• CISAPRIDE
• CILOSTAZOL
• ASTEMIZOLE
• TERFENADINE
• PIMOZIDE
• QUETIAPINE
• ERGOTAMINE
• DIHYDROERGOTAMINE
• LOVASTATIN
• SIMVASTATIN
• ALPRAZOLAM
• TRIAZOLAM
• MIDAZOLAM
• VINBLASTINE

• Avoid intake of acid or heartburn-triggering foods or drinks like onions, peppermint, chocolate, caffeinated beverages, citrus fruits or juices, tomatoes, and high-fat and spicy foods.
• Before going to sleep, try to raise your bedhead so that your head and chest are higher than your feet. Do not use piles of pillows; instead, one raised block is fine. This will not allow the stomach acid to backflow through your food pipe.
• Avoid taking alcohol and smoking cigarettes. Alcohol can raise the level of production of stomach acid leading to heartburn and acid reflux. On the other hand, nicotine smoking damages the valve (sphincter), preventing stomach acid backflow into the food pipe.
• Include fibre-rich foods, berries, cherries, leafy green veggies (kale, spinach), and black peppers in your meal. These foods are full of antioxidants, calcium, and vitamin B 12 that can help cope with the medicine's long-term effects. Fermented dairy products like miso, sauerkraut, and kimchi contain probiotics that help prevent excess stomach acid production. Cranberry juice can be beneficial in peptic ulcers and H Pyroli infection.
• Avoid regular sitting continuously, as it can increase stomach acid production. Try to take a break of 5 minutes in 1 hour by brisk walking or stretching.

• Nexpro HP Combipack may impair liver function. So, your doctor may periodically perform liver function tests to evaluate liver function. 
• Nexpro HP Combipack may affect the test results of urine tests for glucose, blood tests for liver function, and oestriol tests (to check the baby is developing normally during pregnancy), so inform your doctor that you are taking Nexpro HP Combipack before undergoing these tests.

Peptic ulcer disease (H. pylori infection): Helicobacter pylori are bacteria that enter the body and infect the stomach. The bacteria's secretions cause the protective layer of the stomach to weaken, causing the stomach acid to get in contact with the stomach lining. Both acid and bacteria irritate the stomach lining, constantly leading to the formation of sores or ulcers, which is called peptic ulcer disease. H.pylori is the common cause of peptic ulcer disease. Symptoms include stomach pain or discomfort, loss of appetite, weight loss, difficulty swallowing, bloating, nausea, and vomiting.  Severe stomach pain that doesn’t go away, black stools, and severe vomiting indicate a requirement for emergency treatment. Peptic ulcer disease can be cured if the H. pylori infection is successfully treated. So, antibiotics are prescribed to treat the infection. In general, treatment includes one or more antibiotics, along with acid suppressants.