The prevalence of H. pylori infection in Asian populations is roughly 50-60%, and due to its correlation with gastric cancer development and the popularity of non-invasive H. pylori testing methods, more and more patients diagnosed positive for H. pylori are requesting bactericidal treatment, and the current recommended first-line antibiotics include clarithromycin. At the same time, the incidence of metabolic diseases such as hypertension, diabetes mellitus, dyslipidemia and gout is increasing year by year. Inevitably, there are patients suffering from both of these diseases, when special attention needs to be paid to the medication and alert to the adverse reactions caused by the interaction between clarithromycin and the drugs used to treat the above 4 metabolic diseases. The following 4 groups of people need special attention from clinicians and patients: 1. Patients taking calcium antagonists for hypertension Clarithromycin inhibits the metabolism of calcium channel blocker (CCB) nifedipine by inhibiting cytochrome P450 enzyme 3A4 (CYP3A4), leading to adverse reactions such as hypotension. Concomitant prescription of clarithromycin or azithromycin in patients taking CCB was associated with a 2-fold increase in the rate of hospitalization and the risk of developing acute kidney injury. Patients on dihydropyridine CCBs were at highest risk compared to those on diltiazem and verapamil. Nifedipine in particular was associated with a high risk. 2. Patients taking statins for dyslipidemia Clarithromycin has interactions with statins, especially with lovastatin and simvastatin, which are metabolized by CYP3A4. However, a recent analysis of a large health database examining adverse drug reactions in older adults taking statins that are not metabolized by CYP3A4 (rasuvastatin, pravastatin, fluvastatin) found that use of clarithromycin and these same statins was associated with a higher risk of hospitalization due to acute kidney injury or hyperkalemia and a higher all-cause mortality rate. This leads to concerns about the use of clarithromycin in these patients taking lower-risk statins. 3, Patients taking glipizide and glibenclamide for diabetes Clarithromycin increases the drug concentration of glipizide and glibenclamide, which can lead to hypoglycemia. 4.Patients taking colchicine for gout Clarithromycin also has significant interactions with colchicine, and several deaths have been reported.