Is Amoxicillin, Omeprazole and Rifabutin (Talicia) affected by genetics?
Partially. 1 of 3 ingredients has pharmacogenetic evidence.
Amoxicillin, omeprazole and rifabutin contains 3 active ingredients, and 1 of them has published pharmacogenetic guidelines. The relevant gene is CYP2C19. Your genotype can change how that ingredient behaves in your body, while the other ingredients aren't affected by genetics in any clinically established way. The strongest evidence level on this page is Strong, from the published guidelines shown below.
Also sold as Talicia.
Pharmacogenetic guidelines are written for one ingredient at a time, so the guidance below is for each ingredient on its own. What your genes mean for a combination product is less clear, because the dose and the other ingredients can change things. If you take Amoxicillin, omeprazole and rifabutin, it's worth talking over with your prescriber or pharmacist. How we handle combination products.
What's in Amoxicillin, omeprazole and rifabutin
Amoxicillin No known pharmacogenetics
No strong published pharmacogenetic guideline currently applies to amoxicillin.
Omeprazole Affected by CYP2C19
Affected by CYP2C19. Guidance from CPIC, strong evidence.
Read the full omeprazole genetics guideRifabutin No known pharmacogenetics
No strong published pharmacogenetic guideline currently applies to rifabutin.
Omeprazole phenotype recommendations
Published guidance from CPIC on how omeprazole should be dosed or substituted based on your CYP2C19 phenotype.
| Phenotype | What it means | Recommendation | Evidence |
|---|---|---|---|
| Ultrarapid MetabolizerCYP2C19 | Your body clears this drug very quickly, so you may need a higher dose for it to work. | CPIC Increase starting daily dose by 100%. Daily dose may be given in divided doses. Monitor for efficacy. |
Optional |
| Rapid MetabolizerCYP2C19 | Your body clears this drug a bit faster. The usual starting dose is fine, but some conditions may need a higher dose. | CPIC Initiate standard starting daily dose. Consider increasing dose by 50 to 100% for the treatment of Helicobacter pylori infection and erosive esophagitis. Daily dose may be given in divided doses. Monitor for efficacy. |
Moderate |
| Normal MetabolizerCYP2C19 | Your body processes this drug normally. The usual starting dose is fine, but some conditions may need a higher dose. | CPIC Initiate standard starting daily dose. Consider increasing dose by 50 to 100% for the treatment of H. pylori infection and erosive esophagitis. Daily dose may be given in divided doses. Monitor for efficacy. |
Moderate |
| Likely Intermediate MetabolizerCYP2C19 | Your body clears this drug more slowly. A lower dose may be needed for long-term use to prevent side effects. | CPIC Initiate standard starting daily dose. For chronic therapy (>12 weeks) and efficacy achieved, consider 50% reduction in daily dose and monitor for continued efficacy. |
Optional |
| Intermediate MetabolizerCYP2C19 | Your body clears this drug more slowly. A lower dose may be needed for long-term use to prevent side effects. | CPIC Initiate standard starting daily dose. For chronic therapy (>12 weeks) and efficacy achieved, consider 50% reduction in daily dose and monitor for continued efficacy. |
Optional |
| Likely Poor MetabolizerCYP2C19 | Your body clears this drug slowly. A lower dose may be needed for long-term use to prevent side effects. | CPIC Initiate standard starting daily dose. For chronic therapy (>12 weeks) and efficacy achieved, consider 50% reduction in daily dose and monitor for continued efficacy. |
Moderate |
| Poor MetabolizerCYP2C19 | Your body clears this drug slowly. A lower dose may be needed for long-term use to prevent side effects. | CPIC Initiate standard starting daily dose. For chronic therapy (>12 weeks) and efficacy achieved, consider 50% reduction in daily dose and monitor for continued efficacy. |
Moderate |
| IndeterminateCYP2C19 | The impact of your genotype on response to this drug is unknown. | CPIC Initiate therapy with recommended starting dose. |
Not rated |
| Not availableCYP2C19 | The impact of your genotype on response to this drug is unknown. | CPIC Initiate therapy with recommended starting dose. |
Not rated |
Source: CPIC
The gene behind the guidance
CYP2C19 Cytochrome P450 2C19
CYP2C19 handles several SSRIs (citalopram, escitalopram, sertraline), proton pump inhibitors (omeprazole, esomeprazole), and the blood thinner clopidogrel. About 2 percent of people of European ancestry and 13 percent of people of East Asian ancestry are poor metabolizers, and about 30 percent of people of European ancestry are rapid or ultrarapid metabolizers.
For most CYP2C19 drugs, such as the SSRIs and proton pump inhibitors, poor metabolizers build up more drug and rapid or ultrarapid metabolizers clear it faster. Clopidogrel works the other way: it needs CYP2C19 to become active, so poor and intermediate metabolizers get less benefit from it.
See all drugs affected by CYP2C19Browse the full drug class: Proton pump inhibitors.
Related medications
Find out how your genetics affect Amoxicillin, omeprazole and rifabutin
Informational only, not medical advice. Pharmacogenetic guidance describes population-level patterns; your individual response depends on many factors. Never start, stop, or change a medication without talking to your prescribing clinician.