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At a glance

Clarithromycin is a macrolide antibiotic used for the treatment of respiratory tract, ear, nose, throat, lung, skin, and peptic ulcer infections.

Indications
  • 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
Pharmacology

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.

Dosage

Adult Dose:

IndicationDoseScheduleDuration
Acute bronchitis exacerbation250-500 mgEvery 12 hours7-14 days
Acute sinusitis500 mgEvery 12 hours14 days
Community-acquired pneumonia250 mgEvery 12 hours7-14 days
Pharyngitis/Tonsillitis250 mgEvery 12 hours10 days
Uncomplicated skin infections250 mgEvery 12 hours7-14 days
MAC infection500 mgEvery 12 hoursUntil risk is low

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.

Side effects

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.

Use in pregnancy

[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.

Pregnancy Category: C — always consult a doctor before taking during pregnancy.

Precautions & warnings
  • [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).
Overdose effects

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.

Storage conditions

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 — see the full informationPharmacology, precautions, pregnancy, overdose and the rest on the generic page
⚠️ This information is for educational purposes only — not a substitute for medical advice. Consult a registered physician before taking any medicine.