{"id":3847,"date":"2025-03-31T18:11:51","date_gmt":"2025-03-31T18:11:51","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/clarithromycin-txt\/"},"modified":"2025-03-31T18:11:51","modified_gmt":"2025-03-31T18:11:51","slug":"clarithromycin-txt","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/clarithromycin-txt\/","title":{"rendered":"Clarithromycin.txt"},"content":{"rendered":"<h1>Clarithromycin<\/h1>\n<p><H3>  CLINICAL USE <\/H3><br \/>\nAntibacterial agent:Adjunct in treatment of duodenal ulcers  by eradication of Helicobacter pylori<H3> DOSE IN NORMAL RENAL FUNCTION  <\/H3>Oral: 250\u2013500 mg every 12 hoursIV: 500 mg every 12 hours<H3>  PHARMACOKINETICS    <\/H3><LI> Molecular weight &amp;nbsp  &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp  &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp :748<\/li>\n<li>  %Protein binding  &amp;nbsp &amp;nbsp &amp;nbsp  &amp;nbsp  &amp;nbsp  &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp :80<\/li>\n<li>  %Excreted unchanged in urine &amp;nbsp &amp;nbsp : 15\u201340<\/li>\n<p><LI> Volume of distribution (L\/kg) &amp;nbsp &amp;nbsp &amp;nbsp :2\u20134<\/li>\n<p><LI>half-life \u2013 normal\/ESRD (hrs)&amp;nbsp &amp;nbsp &amp;nbsp :3\u20137\/Prolonged<H3>  DOSE IN RENAL IMPAIRMENT <\/H3> <H4>GFR (mL\/MIN)<\/H4>30\u201350 Dose as in normal renal function10\u201330 Oral: 250\u2013500 mg every 12 hours. IV: 250\u2013500 mg every 12 hours<LI> &lt;10 &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp : Oral: 250\u2013500 mg every 12 hours. IV: 250\u2013500 mg every 12 hours. See \u2018Other Information\u2019<H3> DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES  <\/H3><LI> CAPD  &amp;nbsp &amp;nbsp &amp;nbsp  &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp:Unknown dialysability. Dose as in GFR &lt;10 mL\/min <\/p>\n<li> HD &amp;nbsp  &amp;nbsp &amp;nbsp  &amp;nbsp &amp;nbsp  &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp :Dialysed. Dose as in GFR<LI> &lt;10 &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp : mL\/min <LI>HDF\/high flux  &amp;nbsp :Dialysed. Dose as in GFR<LI> &lt;10 &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp : mL\/min<LI>CAV\/VVHD  &amp;nbsp &amp;nbsp &amp;nbsp:Unknown dialysability. Dose as in GFR=10\u201330 mL\/min<H3> IMPORTANT DRUG INTERACTIONS  <\/H3>Potentially hazardous interactions with other drugsAnti-arrhythmics: possibly increased  disopyramide concentrationAntibacterials: increased rifabutin  concentration \u2013 reduce rifabutin dose; clarithromycin concentration reduced by rifamycinsAnticoagulants: effect of coumarins  potentially enhancedAntidepressants: avoid concomitant use  with reboxetineAnti-epileptics: increased carbamazepine  and phenytoin concentration. Antihistamines: metabolism of mizolastine  inhibited \u2013 avoid concomitant useAntimalarials: avoid concomitant  administration with artemether\/lumefantrineAntimuscarinics: avoid concomitant use  with tolterodineAntipsychotics: increased risk of  arrhythmias with pimozide and sertindole \u2013 avoid concomitant use; possibly increased quetiapine concentrationAntivirals: concentration of both drugs  increased with atazanavir; increased risk of rash with efavirenz; oral clarithromycin reduces absorption of zidovudine; concentration increased by ritonavir and tipranavir, also concentration of tipranavir increased \u2013 reduce dose of clarithromycin in renal impairmentAnxiolytics: metabolism of midazolam  inhibitedCalcium-channel blockers: possibly  inhibits verapamil concentrationCiclosporin: increased ciclosporin  concentration (although may take \u2245 5 days after starting clarithromycin before increase in ciclosporin levels is seen)Colchicine: treatment with both agents has  been shown in a study to increase the risk of fatal colchicine toxicity, especially in patients with renal impairment.1 Diuretics: increased eplerenone  concentration \u2013 avoid concomitant useErgot alkaloids: increase risk of ergotism \u2013  avoid concomitant use5 HT 1 agonists: increased eletriptan concentration \u2013 avoid concomitant useIvabradine: increased ivabradine  concentration \u2013 avoid concomitant useLipid-lowering drugs: increased risk  of myopathy with atorvastatin and simvastatin, avoid with simvastatin and max dose of atorvastatin 20 mg.2Sirolimus: possibly increased sirolimus  concentration \u2013 avoid concomitant useTacrolimus: increased tacrolimus levels Theophylline: increased theophylline  concentration.<H3> ADMINISTRATION  <\/H3><H4> Reconstition<\/H4>Add 10 mL water for injection to vial  (500 mg). Add reconstituted product to 250 mL glucose 5% or sodium chloride 0.9%. (Stable in 100 mL, but more likely to cause phlebitis, pain and inflammation at the injection site)<H4>  Route  <\/H4><H4> IV infusion  <\/H4> into one of the larger proximal  veinsNot to be administered by bolus or IM  injection<H4>  Rate of Administration  <\/H4>Over 60 minutes <H4>Comments<\/H4>\u2013<H4>  OTHER INFORMATION  <\/H4>Use with caution in renal or hepatic failure Oral bioavailability is 55% Patients with GFR &lt;10 mL\/min, vomiting  may be a problem with high doses<br \/>\n","protected":false},"excerpt":{"rendered":"<p>Clarithromycin CLINICAL USE Antibacterial agent:Adjunct in treatment of duodenal ulcers<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-3847","post","type-post","status-publish","format-standard","hentry","category-blog","tag-post-by-auto-php"],"_links":{"self":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/3847","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/comments?post=3847"}],"version-history":[{"count":0,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/3847\/revisions"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=3847"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=3847"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=3847"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}