about Clarithromycin class, uses, side effects contraindications
Clarithromycin
Short Description
Clarithromycin is a macrolides antibiotic that works by inhibiting the growth of bacteria.
Clarithromycin is effective in treating mild to moderate infections caused by bacteria sensitive to these antibiotics.
Clarithromycin is usually used to treat the following conditions:?
Sinusitis?.
Inflammation of the middle ear.
Pneumonia?.
bronchitis.
Skin infection.
Sore throat and tonsillitis.
Stomach ulcers caused by Helicobacter pylori when used with other medicines.
Mycobacterium Avium infection in AIDS patients.
Category
Chemical class: Macrolide derivative
Therapeutic class: Antibiotic
Pregnancy category: C
Indications
To treat pharyngitis and tonsillitis caused by Streptococcus pyogenes ORAL SUSPENSION, Adults and adolescents. 250 mg every 12 hr for 10 days. Children.15 mg/kg daily in divided doses every 12 hr for 10 days. To treat acute maxillary sinusitis caused by Haemophilus influenzae, Moraxella catarrhalis, or Streptococcus pneumoniae ORAL SUSPENSION, Adults and adolescents.500 mg every 12 hr for 14 days. Children.15 mg/kg daily in divided doses every 12 hr for 10 days. Adults and adolescents.1,000 mg every 24 hr for 14 days. To treat acute exacerbations of chronic bronchitis caused by H. influenzae, M. catarrhalis, or S. pneumoniae ORAL SUSPENSION, Adults and adolescents. 250 to 500 mg every 12 hr for 7 to 14 days. Children. 15 mg/kg daily in divided doses every 12 hr for 10 days. Adults and adolescents. 1,000 mg every 24 hr for 7 days. To treat uncomplicated skin and softtissue infections caused by Staphylococcus aureus or S. pyogenes ORAL SUSPENSION, Adults and adolescents.250 mg every 12 hr for 7 to 14 days. Children. 15 mg/kg daily in divided doses every 12 hr for 10 days. To treat pneumonia caused by Chlamydia pneumoniae, Mycoplasma pneumoniae, or S. pneumoniae ORAL SUSPENSION, Adults and adolescents. 250 mg every 12 hr for 7 to 14 days. Children.15 mg/kg daily in divided doses every 12 hr for 10 days. To treat pneumonia caused by H. influenzae ORAL SUSPENSION, Adults and adolescents. 250 mg every 12 hr for 7 days. Children.15 mg/kg daily in divided doses every 12 hr for 10 days. To treat acute otitis media caused by H. influenzae, M. catarrhalis, or S. pneumoniae ORAL SUSPENSION, Children. 15 mg/kg daily in divided doses every 12 hr for 10 days. clarithromycin 247 C To treat active duodenal ulcer caused by Helicobacter pylori ORAL SUSPENSION, Adults and adolescents.500 mg every 8 hr for 14 days with omeprazole 40 mg daily in the morning. Then, omeprazole continued at 20 mg daily in the morning days 15 through 28. Or, 500 mg every 12 hr for 14 days with lansoprazole 30 mg and amoxicillin 1 g every 12 hr for 14 days. To prevent or treat Mycobacterium avium complex in patients with HIV infection ORAL SUSPENSION, Adults and adolescents. 500 mg every 12 hr for 7 to 14 days. Children.7.5 mg/kg every 12 hr. Maximum: 500 mg b.i.d.
Mechanism of Action
Inhibits RNA-dependent protein synthesis in many types of aerobic, anaerobic, grampositive, and gram-negative bacteria. By binding with the 50S ribosomal subunit of the bacterial 70S ribosome, clarithromycin causes bacterial cells to die.
Contraindications
Concurrent therapy with astemizole, cisapride, pimozide, or terfenadine; hypersensitivity to clarithromycin, erythromycin, or any macrolide antibiotic
Interactions
astemizole, disopyramide,
quinidine: Possibly prolonged QT interval or torsades de pointes carbamazepine, other metabolized by cytochrome P450 enzyme system: Increased blood levels of these cisapride, disopyramide, pimozide, quinidine, terfenadine: Increased risk of arrhythmias colchicine: Increased risk of colchicine toxicity digoxin: Increased serum digoxin level dihydroergotamine, ergotamine: Risk of acute ergot toxicity lovastatin, simvastatin: Risk of rhabdomyolysis oral anticoagulants: Potentiated anticoagulant effects rifabutin,
rifampin: Decreased blood clarithromycin level by more than 50%
sildenafil: Possibly prolonged blood sildenafil level
theophylline: Increased blood theophylline level triazolam: Possibly increased CNS effects zidovudine: Decreased blood zidovudine level
Side Efect
CNS: Anxiety, confusion, dizziness, fatigue, hallucinations, headache, insomnia, mania, nightmares, seizures, somnolence, tremor, vertigo
CV: Prolonged QT interval, ventricular arrhythmias
EENT: Altered smell, altered taste, glossitis, hearing loss, oral moniliasis, stomatitis, tinnitus, tongue or tooth discoloration
ENDO: Hypoglycemia
GI: Abdominal pain, diarrhea, indigestion, nausea, pancreatitis, pseudomembranous colitis
GU: Anorexia, elevated BUN level, hepatic dysfunction, vomiting
HEME: Leukopenia, neutropenia, increased prothrombin time, thrombocytopenia
SKIN: Pruritus, rash, Stevens-Johnson syndrome, toxic epidermal necrolysis, urticaria
Other: Anaphylaxis, new or worsening myasthenia gravis symptoms, superinfection
Cautions
Expect to obtain a specimen for culture and sensitivity tests before giving first dose. Use clarithromycin cautiously in patients with renal impairment. Be aware that patients with severe renal impairment may need decreased dosage or prolonged dosage interval and that clarithromycin is not recommended in combination with ranitidine bismuth citrate therapy if patient has a creatinine clearance less than 2.5 ml/min/1.73 m2or a history of acute porphyria. Assess patient’s bowel pattern daily; severe diarrhea may indicate pseudomembranous colitis caused by Clostridium difficile. If diarrhea occurs, notify prescriber and expect to withhold clarithromycin and treat with fluids, electrolytes, protein, and an antibiotic effective against C. difficile. PATIENT SAFTY
Stress the importance of taking the full course of clarithromycin exactly as preclarithromycin 248 scribed, even after feeling better. Caution patient not to crush or chew tablets. Advise patient to take drug with food if he takes tablets or has GI distress. If patient takes suspension form, instruct him not to refrigerate it. Tell patient to report severe nausea, rash, or itching. Instruct patient not to take OTC or prescription without consulting prescriber of clarithromycin. Urge patient to immediately report watery, bloody stools to prescriber, even if they occur up to 2 months after therapy has ended.
Trade Name & Company Name
effect of Clarithromycin in Pregnancy, Fetal Health
and Breast feeding
Pregnancy
. Clarithromycin is used for the treatment of lower respiratory tract infections, GU tract infections, skin infections, neutropenic patients, AIDS-related infections, acute maxillary sinusitis, and active duodenal ulcer. There are no adequate reports or well- controlled studies in pregnant women. It has been suggested that H. pylori infection might be a cause of persistent hyperemesis gravidarum. Clarithromycin has also been used successfully for the treatment of Q fever, Mediterranean spotted fever and MAC during pregnancy. Studies in rats, rabbits, and monkeys indicate clarithromycin does not impair fertility. Fetal Health
There are no adequate reports or well-controlled studies in human fetuses. Clarithromycin crosses the human placenta to a greater degree than other macrolides (6% maternal dose), making it a candidate in treatment trials of genital Mycoplasma and Ureaplasma infections during pregnancy. Post-marketing studies are reassuring. No teratogenic effects are noted in most studies of 212 rats, rabbits, and monkeys. However, there are reports of a modest increase in CV malformations and cleft palate in certain rodent strains. Breastfeeding
There are no adequate reports or well-controlled studies in nursing women. Clarithromycin enters human breast milk, reaching levels as high as 75% of the maternal concentration.
the follwing drugs will increse Clarithromycin by inhepiting cyp450
amiodarone ; aprepitant ; atomoxetine ; boceprevir ; ceritinib ; chloramphenicol ; cimetidine ; ciprofloxacin ; clarithromycin ; crizotinib ; delaviridine ; diethyl-dithiocarbamate ; diltiazem ; entrectinib ; erythromycin ; esomeprazole ; fluconazole ; fluvoxamine ; gestodene ; grapefruit juice ; idelalisib ; imatinib ; indinavir ; itraconazole ; ivacaftor ; ketoconazole ; lesinurad ; letermovir ; mibefradil ; mifepristone ; nefazodone ; nelfinavir ; netupitant/palonosetron ; norfloxacin ; norfluoxetine ; omeprazole ; pantoprazole ; perampanel ; quercetin ; regorafenib ; ribociclib ; ritonavir ; rucaparib ; saquinavir ; simeprevir ; starfruit ; telaprevir ; telithromycin ; ticagrelor ; tucatinib ; verapamil ; voriconazole ;
the follwing drugs will decrease Clarithromycin by inhancing cyp450
barbiturates ; brigatinib ; carbamazepine ; clobazam ; dabrafenib ; efavirenz ; elagolix ; enzalutamide ; eslicarbazepine ; glucocorticoids ; letermovir ; lorlatinib ; modafinil ; nevirapine ; oxcarbazepine ; perampanel ; phenobarbital ; phenytoin ; pioglitazone ; rifabutin ; rifampin ; St. John's Wort ; telotristat ; troglitazone ; vemurafenib ;
trad drugs based on Clarithromycin
| Gen name | Trade name | Catagory name |
| amoxicillin / clarithromycin / lansoprazole | Prevpac | H2 antagonists |
| amoxicillin / clarithromycin / omeprazole | Omeclamox-Pak | H2 antagonists |
| clarithromycin | Biaxin | Macrolides |
| clarithromycin | Biaxin XL | Macrolides |
| Clarithromycin | CLAMYCIN 250 MG TABLET | |
| Clarithromycin | CLAREX 250MG TABLET | |
| Clarithromycin | CLARIDAR | |
| Clarithromycin | CLARIMAC | |
| Clarithromycin | EMIMYCIN 250 MG TABLETS | |
| Clarithromycin | KLACID 125MG-5ML SUSP | |
| Clarithromycin | KLACID 250MG TAB | |
| Clarithromycin | KLARIBAC 250MG TAB | |
| Clarithromycin | KLARIBAC 500 MG FILM COATED TABLETS | |
other drugs from same cataogory