Missing Two Pills: Should I Consult My Doctor About H. Pylori Treatment? - Gastroenterology and Hepatology

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If you are missing two pills of the medication for Helicobacter pylori, should you see a doctor again?


Hello, last week I had an endoscopy that revealed a mild ulcer and the presence of Helicobacter pylori.
My doctor prescribed medication for the Helicobacter pylori infection, which includes Periscon, Amipasole (esomeprazole), Klarith (clarithromycin) antibiotic, and Amoxicillin antibiotic.
The treatment is for two weeks, but my dad seems to have an upset stomach and took two of my Amipasole pills without permission, so I will be short those two pills on the last day of my treatment.
Will this have any impact? Thank you for your response.

Miss Sun, 20~29 year old female. Ask Date: 2020/10/11

Dr. Chen Shidian reply Gastroenterology and Hepatology


It is advisable to cooperate with the implementation of the triple therapy as much as possible.
However, generally speaking, reducing the intake of stomach medications for two days should not significantly affect the success rate of eradication.

Reply Date: 2020/10/11

More Info


When it comes to treating H. pylori infections and associated conditions like gastric ulcers, adherence to the prescribed medication regimen is crucial for effective treatment. In your case, you have been prescribed a combination of medications, including Periscon, Esomeprazole (Amipasole), Klarithromycin, and Amoxicillin, which are typically used to eradicate H. pylori and promote healing of the gastric mucosa.

Missing two doses of Esomeprazole, especially towards the end of your treatment, can potentially impact the effectiveness of your therapy. Esomeprazole is a proton pump inhibitor (PPI) that reduces stomach acid production, creating a less acidic environment that is conducive to the healing of ulcers and enhances the efficacy of antibiotics against H. pylori. If the acid suppression is not maintained consistently, it may hinder the antibiotics' ability to work effectively, potentially leading to incomplete eradication of the bacteria.

While missing two doses may not completely negate the treatment's effectiveness, it is advisable to consult your healthcare provider. They can assess your situation and determine if any adjustments are needed, such as extending the treatment duration or possibly repeating the therapy if necessary. Additionally, they may want to monitor your symptoms and possibly conduct follow-up testing to ensure that the H. pylori infection has been successfully eradicated.

In the meantime, here are some general recommendations to consider:
1. Continue Taking Your Medications: Make sure to take the remaining medications as prescribed. Do not skip any more doses, and ensure that you complete the full course of antibiotics and the PPI.

2. Monitor Symptoms: Keep an eye on any symptoms you may experience, such as abdominal pain, nausea, or changes in bowel habits. If you notice any worsening of symptoms or new symptoms, contact your healthcare provider promptly.

3. Avoid Self-Medication: Do not take any additional medications or over-the-counter remedies without consulting your doctor, as they may interfere with your treatment.

4. Discuss with Family: Since your father mistakenly took your medication, it might be helpful to discuss the importance of your treatment with him to prevent similar incidents in the future.

5. Follow-Up Appointment: Schedule a follow-up appointment with your healthcare provider to discuss your treatment progress and any concerns you may have regarding the missed doses.

In conclusion, while missing two doses of Esomeprazole may not completely derail your treatment, it is essential to consult your doctor for personalized advice and to ensure the best possible outcome for your H. pylori treatment. Your healthcare provider will be able to guide you on the next steps and help you achieve a successful resolution of your gastric issues.

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