Clarithromycin

Clarithromycin is an antibiotic used to treat various types of infections. It is effective in most infections of the respiratory tract, ear, nose, throat, lungs, and skin. It is also effective against a bacteria known as H. pylori, which is associated with peptic ulcer disease. Clarithromycin is also effective against some infections (e.g., MAC or Mycobacterium avium complex) seen in people with reduced immunity. It stops the bacteria from growing, which helps to resolve your symptoms and cure your infection. This medicine is taken orally, preferably either one hour before or 2 hours after a meal. No antacids should be taken 2 hours before or after taking this medicine.

Clarithromycin is an antibiotic. It works by preventing synthesis of essential proteins required by bacteria to carry out vital functions. Thus, it stops the bacteria from growing, and prevents the infection from spreading.

• Acute bacterial exacerbation of chronic bronchitis
• Acute maxillary sinusitis
• Community-acquired pneumonia
• Pharyngitis or tonsillitis
• Uncomplicated skin and skin structure infections
• Acute otitis media in pediatric patients
• Treatment and prophylaxis of disseminated mycobacterial infections
• Helicobacter pylori infection and duodenal ulcer disease

Clarithromycin acts by inhibiting microsomal protein synthesis in susceptible organisms mainly by binding to the donor site on the 50S subunit of the bacterial ribosome and preventing translocation to that site. Clarithromycin is active against most Gram-positive bacteria and Chlamydia, some Gram-negative bacteria and Mycoplasmas. Clarithromycin's activity is the same as, or greater than, that of Erythromycin in vitro against most Gram-positive bacteria. Clarithromycin is more acid-stable than Erythromycin and therefore, is better tolerated.

Clarithromycin binds to the 50S subunit of the bacterial ribosome, inhibiting protein synthesis, which stops bacterial growth and prevents the infection from spreading.

Adult Dose:

H. pylori (Triple therapy): Clarithromycin 500 mg + Lansoprazole 30 mg + Amoxicillin 1 g (every 12 hours) for 10 or 14 days.

Pediatric Dose: 15 mg/kg/day (every 12 hours) for 10 days; Mycobacterial infections: 7.5 mg/kg every 12 hours (max 500 mg).

Renal Dose: Reduce dose or prolong intervals in severe renal impairment.

Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Clarithromycin may be taken with or without food, but it is better to take it one hour before or two hours after a meal. No antacids should be taken 2 hours before or after taking this medicine.

If you miss a dose of Clarithromycin, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.

Common Side Effects:

• Abdominal pain
• Diarrhea
• Headache
• Nausea
• Taste change
• Vomiting
• Indigestion
• Rash

Serious Side Effects: Allergic reactions (anaphylaxis), QT prolongation, hepatitis, pseudomembranous colitis, exacerbation of myasthenia gravis.

• [UNSAFE] Clarithromycin may decrease alertness, affect your vision or make you feel sleepy and dizzy. Do not drive if these symptoms occur.
• Discontinue if severe acute hypersensitivity reactions occur.
• Avoid in patients with known QT prolongation, ventricular arrhythmia, hypokalemia, hypomagnesemia, or significant bradycardia.
• Discontinue if signs and symptoms of hepatitis occur.
• If diarrhea occurs, evaluate for Clostridium difficile associated diarrhea (CDAD).

• Hypersensitivity to clarithromycin, erythromycin, or other macrolide antibacterial drugs
• History of cholestatic jaundice or hepatic dysfunction associated with prior use of clarithromycin

Contraindicated co-administration: HMG-CoA reductase inhibitors (lovastatin, simvastatin), gastroprokinetic agents (cisapride), ergot alkaloids (ergotamine, dihydroergotamine), antipsychotics (pimozide, quetiapine), anti-gout agents (colchicine).

Not recommended: Antiarrhythmics (disopyramide, quinidine, dofetilide, amiodarone, sotalol, procainamide).

[SAFE] Consuming alcohol with Clarithromycin does not cause any harmful side effects.

[CONSULT YOUR DOCTOR] Clarithromycin may be unsafe to use during pregnancy. Although there are limited studies in humans, animal studies have shown harmful effects on the developing baby. Your doctor will weigh the benefits and any potential risks before prescribing it to you. Pregnancy Category C.

[SAFE IF PRESCRIBED] Clarithromycin is safe to use during breastfeeding. Human studies suggest that the drug does not pass into the breastmilk in a significant amount and is not harmful to the baby.

Pediatric dose: 15 mg/kg/day (every 12 hours) for 10 days; Mycobacterial infections: 7.5 mg/kg every 12 hours (max 500 mg). Safety in children under 6 months has not been established.

Limited information is available regarding dose adjustment for elderly patients.

[CAUTION] Clarithromycin should be used with caution in patients with kidney disease. Dose adjustment may be needed. Reduce dose or prolong intervals in severe renal impairment.

[SAFE IF PRESCRIBED] Clarithromycin is probably safe to use in patients with liver disease. Limited data available suggests that dose adjustment may not be needed.

Large amounts may cause gastrointestinal symptoms. 8 grams ingestion resulted in altered mental status, paranoid behavior, hypokalemia, and hypoxemia. Hemodialysis or peritoneal dialysis does not significantly affect clarithromycin serum levels.

Store in a cool and dry place, protected from light & moisture. The reconstituted suspension must be used within 7 days at room temperature and within 14 days when refrigerated. Keep out of reach of children.

Clarithromycin