Roxithromycin nausea

The effect of lansoprazole on roxithromycin concentrations in plasma and gastric tissue have been investigated in 12 healthy volunteers who took lansoprazole 30 mg bd with or without roxithromycin 300 mg bd over 6 days (3). The medications were well tolerated, with only mild adverse events. The more frequent adverse events were nausea, bloating, and diarrhea. Lansoprazole and roxithromycin did not alter the systemic availability of each other. However, lansoprazole increased the local concentration of the antibiotic in the stomach. 

The gastrointestinal adverse effects are the most common untoward effects of the macrolides (Table 2). Nausea and vomiting associated with abdominal pain and occasionally diarrhea can be minor and transitory or, in a small percentage of patients, become severe enough to result in premature withdrawal. The rate of these adverse effects varies among the different antibiotics. In general, newer macrolides, such as azithromycin, clarithromycin, or roxithromycin, are better tolerated and cause fewer adverse effects than erythromycin. 

In 2917 adults, adverse effects of roxithromycin occurred in 4.1% at a dosage of 150 mg/day (I). Nausea (1.3%), abdominal pain (1.2%), and diarrhea (0.8%) were the most frequently reported events, whereas rash, vomiting, headache, dizziness, pruritus, urticaria, and constipation were reported only rarely. Treatment had to be withdrawn in 0.9% of the patients because of adverse effects. 

Placebo-controHed studies In a doubleblind study, 31 adults with early rheumatoid arthritis who had not previously received disease-modifying antirheumatic drugs were randomized to oral roxithromycin 300 mg/day or placebo for 3 months [133 ]. There were adverse events in 11 who took roxithromycin and seven who took placebo. The most common adverse events (>5%) were nausea, abdominal pain, headache, and dry mouth. There were no dose-Umiting adverse effects. One patient taking roxithromycin withdrew because of severe emesis. 

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