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Why it's used

Clarithromycin is a prescription medicine that is used to prevent & treat inflammation of the pharynx and tonsils (pharyngitis/tonsillitis) caused by bacteria Streptococcus pyogenes. This medicine works by preventing the synthesis of protein in bacteria which is responsible for the infection. This medicine helps by preventing the bacterial infection. Clarithromycin is also used to treat inflammation and swelling of cavities around nasal passages, (known as acute maxillary sinusitis) caused by bacteria Haemophilus influenzae, Moraxella catarrhalis or Streptococcus pneumoniae, to treat sudden worsening of symptoms of lung disease such as shortness of breath (acute bacterial exacerbation of long-term bronchitis) caused by bacteria Haemophilus influenzae, Haemophilus parainfluenzae, Moraxella catarrhalis, or Streptococcus pneumoniae, to treat community-acquired pneumonia caused by bacteria Haemophilus influenzae, Mycoplasma pneumoniae, Streptococcus pneumoniae, or Chlamydia pneumoniae, to treat uncomplicated skin, skin structure and soft tissue infections of mild to moderate severity such as folliculitis, cellulitis, erysipelas caused by bacteria Staphylococcus aureus, or Streptococcus pyogenes, to treat an infectious disease that occurs mostly in immunocompromised patients (disseminated mycobacterial infections) caused by bacteria Mycobacterium avium, or Mycobacterium intracellulare, to treat middle ear infection (acute otitis media) in children, and to prevent bacterial infection (disseminated Mycobacterium avium complex disease) in patients with advanced HIV infection.
Clarithromycin may also be used along with other medicines in the treatment of certain conditions as recommended by the doctor. It is used with Amoxicillin, or Lansoprazole or Omeprazole to treat infections caused by Helicobacter pylori and duodenal ulcer disease, which are stomach ulcers (active or 5-years history of duodenal ulcer). It is also used together with Omeprazole, or Ranitidine Bismuth Citrate to treat stomach ulcer (active duodenal ulcer) caused by bacterial infection of Helicobacter pylori. It is also used together with Omeprazole to treat infections caused by various strains of Helicobacter pylori bacteria.
When not to use
Clarithromycin should not be used to treat viral infections such as common cold.
Macrolide Antibacterial
Clarithromycin belongs to the Macrolide Antibacterial class of medicines. Macrolide antibacterials are a class of antibiotics that are used to treat certain kinds of bacterial infections. They are commonly used to treat mild-to-moderate bacterial infections.

How to use

Follow directions on the product label, information guide, and provided by your doctor before using Clarithromycin. Consume this medicine as per your doctor's instructions.
Clarithromycin is consumed with or without food. Clarithromycin tablets and Clarithromycin oral suspension should be taken with or without food every 8-12 hours for 7 to 14 days whereas Clarithromycin extended-release tablets should be taken with food every 24 hours for 7 to 14 days. Clarithromycin tablets should be swallowed whole and should not be chewed, broken or crushed.
The typical adult dose of Clarithromycin is 250-500 mg every 12 hours for 7-14 days. The typical dose for children is 15 mg/kg/day (6.8 mg/lb/day) every 12 hours for 10 days. The maximum dose for adults of Clarithromycin is 1000 mg per day. This medicine is commonly used for a period of 10 days for inflammation of the pharynx and tonsils, 14 days for inflammation and swelling of cavities around nasal passages, 7-14 days for acute bacterial exacerbation of long-term bronchitis, 7-14 days for community-acquired pneumonia, and 7-14 days for uncomplicated skin, skin structure and soft tissue infections. Clarithromycin is typically used at the same time every day.
This medicine should be used on an as-needed basis. Depending on the condition of the patient, Clarithromycin can be used for a longer time as advised by the doctor. Also, therapy with Clarithromycin can be used for long-term if clinical and mycobacterial improvements are seen. You should continue to use this medicine as directed by the doctor even if you feel well.
Tell your doctor if your condition does not improve or worsens. Talk to your doctor if diarrhea, and watery and bloody stools. If you have any kidney disease, In case of severe kidney damage with or without existing liver damage, reduction in dosage or prolonged intervals between dosage may be considered. In patients who have severe kidney damage, the dose of Clarithromycin should be reduced by half. Consult with your doctor before stopping the use of Clarithromycin.
To see the impact of Clarithromycin on the body, your doctor may recommend a lower initial dose. Please follow your doctor's instructions carefully. Older patients may see an increase in the risk of side-effects. Hence, a lower dose may be recommended.
If you are giving Clarithromycin to a child, be sure to use a product that is meant for use in children. Before giving this medicine, use the child's weight or age to find the right dose from the leaflet or product package. You can also read the dosage section of this page to know the correct dose for your child. Else, consult with your doctor and follow their recommendation.
If using the liquid form of this medicine, measure the dose using the provided measuring cup, spoon, or dropper. Before pouring the medicine into the measuring device, you should check the measurement markings carefully. Then, pour the dose amount into the device. After use, clean and store the measuring device in a safe place for your next use. You should not use a tablespoon or teaspoon as the dose measuring devices since it can result in an incorrect dose. If indicated on the product package, shake the medicine before use.
To decrease the possibility of side-effects, you might be recommended to use the extended-release form of this medicine by your doctor. The extended-release medicine helps in maintaining a steady level of the medicine in your body for a longer period of time. Do not crush or chew the medicine, unless indicated on the package or by your doctor.
Medicines may be given for uses other than those listed in the medicine guide. Do not use Clarithromycin for symptoms for which it was not prescribed. Do not give Clarithromycin to others who may have similar symptoms as you. Self-medication can cause harm.
Store Clarithromycin 15°C to 30°C (59°F to 86°F), away from moisture, and away from light. Keep this medicine away from children and pets.

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How to take Clarithromycin

Your dose may depend on several personal factors. You should consult with your doctor to find out the dose that is best for you. The dose of Clarithromycin depends on the following factors:
  • patient's age
  • patient's weight
  • patient's health
  • the health of the patient's liver
  • medicines recommended by your doctor
  • any other medicines in use
  • herbal supplements consumed

Clarithromycin Dosage

Dosage for inflammation of the pharynx and tonsils

Adult
  • Recommended: 250 mg every 12 hours for 10 days

Dosage for infection of the lower sinuses (acute maxillary sinusitis)

Adult
  • Recommended: 500 mg every 12 hours for 14 days or 1000 mg every 24 hours for 14 days

Dosage for inflammation or irritation in the bronchial tubes (acute exacerbation of long-term bronchitis)

Adult
  • Recommended: 250-500 mg every 12 hours for 7-14 days or 1000 mg every 24 hours for 7 days

Dosage for lung infection acquired outside hospital (community-acquired pneumonia)

Adult
  • Recommended: 250 mg every 12 hours for 7-14 days or 1000 mg every 24 hours for 7 days

Dosage for community-acquired pneumonia due to bacteria Haemophilus parainfluenzae and Moraxella catarrhalis

Adult
  • Recommended: 1000 mg every 24 hours for 7 days

Dosage for bacterial infection of the skin and associated tissues (uncomplicated skin and skin structure)

Adult
  • Recommended: 250 mg every 12 hours for 7-14 days

Dosage for prevention of widely spreaded Mycobacterium avium disease

Adult
  • Recommended: 7.5 mg/kg or 3.5mg/lb twice a day
  • Initial: 500 mg twice a day
  • Maximum: 500 mg twice a day

Dosage for middle ear infection (acute otitis media) in children

Children
  • Recommended: 7.5 mg/kg or 3.40 mg/lb every 12 hours

Minimum Age

6 months

Dosage calculation for children

To calculate the dosage for children please use the weight based dose calculator to calculate the appropriate dosage as per the weight of your child.

Forms

Suspension
Strength: 125 mg/5ml and 250 mg/5ml
Granules, for suspension
Strength: 125 mg/5ml, 125 mg, 250 mg, and 250 mg/5ml
Tablet
Strength: 250 mg and 500 mg
Tablet, extended release
Strength: 500 mg
Tablet, film coated
Strength: 250 mg and 500 mg
Tablet extended release, film coated
Strength: 500 mg and 1000 mg
Tablet, coated
Strength: 250 mg and 500 mg

Special Instructions

Oral suspension
It is given with or without food. Add half of the amount of water to the bottle and then shake quickly. Add the rest of the liquid to the bottle and shake.
Extended-release tablets
It should be taken with food.

Missed Dose

A missed dose should be taken as early as you remember it. However, if the time for the next dose is almost there, then the missed dose should be skipped, and the regular dosing schedule should be continued. Avoid taking a repeated dose to make up for a missed one.

Overdose

What to do if you overdose on Clarithromycin?
In case of overdose, the patient should be treated by the inducing elimination of unabsorbed drug and proper supportive measures.
Symptoms of an overdose of Clarithromycin
If you use too much of this medicine, it could lead to dangerous levels of the medicine in your body. In such cases, symptoms of an overdose may include:
If you think you have overdosed on Clarithromycin, call a poison control center immediately. You can look up the poison control center information from the Poison Center Finder at TabletWise.com.

Precautions while using Clarithromycin

Before you use Clarithromycin, discuss with your doctor if you are allergic to it or its ingredients. Your doctor may prescribe an alternative medicine and update your medical records to record this information. Tell your doctor if you are allergic any of the following substances: erythromycin or any other macrolide.
Before you use Clarithromycin, tell your doctor of your medical and health history including the following: yellowish discoloration of the skin, liver dysfunction, group of disorders that affect nervous system (acute porphyria), abnormally low levels of potassium, abnormally low levels of magnesium, decreased heartbeat, or abnormal heartbeats (QT prolongation, ventricular arrhythmia of the heart, including torsades de pointes). In case of a history of liver dysfunction, the patients should be advised to discontinue the use of the drug and contact the doctor if symptoms such as severe eating disorder (anorexia), yellow discoloration of the skin (jaundice), dark urine, intense itching, or stomach inflammation (tender abdomen) are seen. Before having surgery during the use of Clarithromycin, discuss with your doctor and dentist about the medicinal products you use including prescription/non-prescription/herbal medicines.
The use of this medicine may change kidney (blood urea nitrogen and blood creatinine). The values of kidney parameters are found to increase with the use of Clarithromycin.
The use of Clarithromycin may change white blood cells. The values of white blood cells are found to decrease and the time taken by blood to clot is increased (prothrombin time) with the use of Clarithromycin.
The use of this medicine may change liver enzymes levels such as alanine transaminase, aspartate transaminase, gamma-glutamyltransferase, GGT alkaline phosphatase, lactate dehydrogenase, and total bilirubin. The values of liver enzymes are found to increase with the use of Clarithromycin.
Clarithromycin can make you feel sleepy. Be careful when using any machinery, driving a vehicle, or doing any other activity that needs you to be fully alert. The consumption of alcohol with Clarithromycin can worsen the sleepiness. Clarithromycin may cause rarely seizures in some people. If you perform any activities where a loss of consciousness may cause harm to you (or others), you should discuss with your doctor.
The use of Clarithromycin during pregnancy should only be when required. Clarithromycin should only be used during pregnancy only if any other treatment is not available. The use of Clarithromycin Clarithromycin while breastfeeding should only be when required. It is not known if Clarithromycin is excreted in human milk. As most of the drugs are excreted in human milk, so caution should be taken when Clarithromycin is given to a breastfeeding woman. Consult with your doctor on the use of Clarithromycin, if you are trying to conceive. If a patient wants to become pregnant or becomes pregnant while taking Clarithromycin, the potential hazards to the fetus should be informed to the patient.
Clarithromycin may cause increased incidence of side-effects in older patients. Elderly patients may see an increased risk of increased or decreased heart rhythm (QT interval and torsades de pointes), reversible hearing loss, and colchicine poisoning due to the combined use of colchicine and Clarithromycin.
Clarithromycin may cause an increased risk of side-effects in children. Children using this medicine may see an increased risk of diarrhea, headache, stomach pain, vomiting, and side-effects related to the digestive system.
Long-term use of Clarithromycin with other antibiotics may result in an increased number of non-susceptible bacteria and fungi which may result in a superinfection.

Clarithromycin Side-effects

The following side-effects may commonly occur when using Clarithromycin. If any of these side-effects worsen or last for a long time, you should consult with your doctor:
The following side-effects may commonly occur in children when using Clarithromycin. Discuss with your doctor if any of these side-effects last for a long time or are severe:
Rarely, the use of Clarithromycin may cause the following side-effects:
The following severe side-effects may also occur when using Clarithromycin:
  • Psychiatric disorders
    Symptoms: insomnia, anxiety, nervousness, psychotic disorder, confusional state, altered state of self-awareness and identity (depersonalization), depression, mental confusion (disorientation), hallucination, abnormal dreams madness (mania)
  • metabolism and nutrition disorders
    Symptoms: abnormally low body weight (anorexia) decreased appetite
  • Immune system disorders
    Symptoms: allergic reaction, severe allergic reaction (anaphylactoid reaction) swelling of the lower layer of skin
    Discontinuation of Clarithromycin therapy should immediately be done and appropriate treatment should be initiated urgently.
  • Blood and lymphatic system
    Symptoms: a decrease in the number of white blood cells, abnormally lowered white blood cells, a high number of blood cells, increase in the number of eosinophils, lack of granulocytes abnormally low levels of thrombocytes
  • Infections and infestations disorders (Clostridium difficile associated diarrhea has been observed with use of almost all antibacterial agents including Clarithromycin, and may vary in severity from moderate diarrhea to fatal colitis.)
    Symptoms: cellulitis, fungal infection on the skin, inflammation of the lining of the intestines, infection, vaginal infection, inflammation of the colon bacterial skin infection
    It is necessary to have a careful medical history. Discontinuation of Clarithromycin therapy should be considered nevertheless of the indication. Adequate treatment should be started, and microbial testing should be done. Drugs preventing muscle contractions (peristalsis) should be avoided.
  • Nervous system disorders
    Symptoms: dysfunction of the sense of taste, headache, taste change, loss of consciousness, abnormality of voluntary movement (dyskinesia), dizziness, drowsiness, tremor, irregular movement of the body (convulsion), loss of taste functions of the tongue, abnormality in the sense of smell, loss of the sense of smell abnormal sensation in the body
  • Ear and labyrinth disorders
    Symptoms: vertigo, hearing problems, ringing in the eyes deafness
  • Cardiac disorders
    Symptoms: heart attack, irregular heart rate, heart rhythm disorder, extrasystoles in the lower chamber of the heart, palpitations, abnormal heart rhythm, rapid heart rate heart rhythm disturbance
    Possibly fatal
  • Vascular disorders
    Symptoms: vasodilation serious bleeding (haemorrhage)
  • Respiratory, thoracic and mediastinal disorders
    Symptoms: shortness of breath (asthma), nosebleed (epistaxis) blockage of an artery in the lungs (pulmonary embolism)
Your doctor has prescribed this Clarithromycin because they have judged that the benefits outweigh the risks posed by side-effects. Many people using this medicine do not have serious side-effects. This is not a complete list of possible side-effects for Clarithromycin.
If you experience side-effects or notice other side-effects not listed above, contact your doctor for medical advice. You may also report side-effects to your local food and drug administration authority. You can look up the drug authority contact information from the Drug Authority Finder at TabletWise.com.

Warnings

Use in pregnancy

Pregnant women are at an increased risk when using this medicine. Clarithromycin should not be used by pregnant women except in clinical situations where no alternative treatment is adequate. The patient should be informed about the possible hazard to the fetus while taking Clarithromycin.

Liver damage

Patients with liver damage are at an increased when using this medicine. Clarithromycin usage has increased the risk of liver dysfunctioning, including increased liver enzymes, and liver cancer or inflammation of liver cells, with or without jaundice. In some cases, liver failure with fatal outcome has seen and found to be associated with severe underlying diseased conditions. Clarithromycin should be discontinued immediately if signs and symptoms of hepatitis occur.

Heart rhythm disorder

Patients with heart problems and elderly patients are at an increased risk when using this medicine. Clarithromycin usage may increase the risk of abnormal heart rhythm and irregular heartbeat. Fatalities have been observed. Clarithromycin should be avoided in patients with ongoing proarrhythmic conditions such as untreated low level of potassium or low level of magnesium, clinically significant decreased heart rate. Patients taking procainamide, quinidine or dofetilide, sotalol, amiodarone antiarrhythmic agents should also avoid the use of Clarithromycin.

Use of antibacterial agents including Clarithromycin

Patients using antibacterial agents including Clarithromycin are at an increased risk when using this medicine. These patients may have reported with Clostridium difficile-associated diarrhea and may vary in severity from moderate diarrhea to possibly fatal colitis. When treated with antibacterial agents the normal flora of the colon gets altered, leading to overgrowth of C. difficile bacteria. It is necessary to have a careful medical history. Discontinuation of Clarithromycin therapy should be done regardless of the indication. Microbial testing should be carried out and adequate treatment should be started. Drugs preventing contraction and relaxation of muscles should be avoided.

Interactions with Clarithromycin

When two or more medicines are taken together, it can change how the medicines work and increase the risk of side-effects. In medical terms, this is called as a Drug Interaction.
Clarithromycin interacts with theophylline, which is used for the treatment of respiratory disorders. The use of Clarithromycin and theophylline together result in increased blood levels of theophylline. Theophylline levels in the blood should be monitored in the patients who are on treatment with high doses of theophylline.
There may be an interaction of Clarithromycin with terfenadine, which is used to treat allergic reactions. When Clarithromycin is used in combination with terfenadine, the level of an active breakdown product of terfenadine was three times greater as compared to the case when terfenadine is given alone. The use of Clarithromycin and terfenadine at the same time is not recommended.
Clarithromycin may interact with carbamazepine, which is used in the treatment of epilepsy and neuropathic pain. When Clarithromycin is used in combination with carbamazepine, an increase in the blood levels of the carbamazepine occurs. Monitoring of blood levels of carbamazepine should be considered.
Your doctor's guidelines may need to be followed while taking this medicine along with omeprazole, which is used to treat acidity problems. When Clarithromycin is used in combination with omeprazole, the levels of omeprazole in the blood are increased in comparison to when omeprazole is given alone.
Special instructions need to be followed while taking this medicine along with verapamil, which is a calcium channel blocker used in the treatment of heart problems. The use of Clarithromycin and verapamil together results in symptoms such as low blood pressure, decreased heart rate, and accumulation of lactic acid which reduces the pH of blood excessively (lactic acidosis). Caution is advised when verapamil and other calcium channel blockers such as verapamil, amlodipine, diltiazem are given in combination with Clarithromycin.
Your doctor's guidelines may need to be followed while taking this medicine along with digoxin, which is used to treat various heart problems. When Clarithromycin is given in combination with digoxin, inactivation of P-glycoprotein by Clarithromycin may result in an increased absorption of digoxin. It may also result in serious harmful effects in some patients irregular heartbeat that can be possibly fatal. Levels of digoxin in the blood should be monitored carefully, especially in the patients who have with digoxin level in the upper therapeutic range.
Special instructions need to be followed while taking this medicine along with oral anticoagulants, which are used to prevent clotting of blood. Use of Clarithromycin along with oral anticoagulants enhances the effect of anticoagulants. Patients taking Clarithromycin and anticoagulants should carefully monitor the time that blood takes to clot (prothrombin time).
Clarithromycin interacts with ritonavir, which is a protease inhibitor used in the treatment of HIV/AIDS. The use of Clarithromycin together with ritonavir results in an increased level of Clarithromycin in the blood and a decrease in the breakdown product of Clarithromycin. Patients who are on treatment with both the drugs require no adjustment of dosage in patients with the normal functioning of kidneys taking ritonavir. As the levels of the breakdown product of Clarithromycin are significantly decreased, treatment with other antibacterial therapy should be taken into consideration. The dose of Clarithromycin more than 1000 mg a day should not be given together with protease inhibitors.
There may be an interaction of Clarithromycin with fluconazole, which is used to treat fungal infections. When Clarithromycin is given in combination with fluconazole, the blood levels of Clarithromycin are increased. There is no need to adjust the dose when Clarithromycin is given together with fluconazole.
Clarithromycin may interact with zidovudine, which is used to prevent and treat HIV/AIDS. When Clarithromycin is used in combination with zidovudine, the blood levels of zidovudine are decreased in comparison to when zidovudine is given alone. The use of both the drugs should be separated by a time interval of 2-4 hours.
Your doctor's guidelines may need to be followed while taking this medicine along with Triazolobenzodiazepines including alprazolam, midazolam, and triazolam, which are used to treat anxiety disorders. When an oral and intravenous dose of midazolam is given in combination with Clarithromycin, 500 mg twice a day for 7 days, the exposure of the body to the drug (AUC) is increased. Also, the use of triazolam with Clarithromycin may result in the effects on the central nervous system including sleepiness and confusion. When Clarithromycin is given in combination with an oral dose of midazolam, triazolam or alprazolam, adjustment of dose should be done cautiously and appropriately. The patient should be monitored for any increase in the medicinal effects on the central nervous system.
Special instructions need to be followed while taking this medicine along with tolterodine, which is used in the treatment of involuntary leakage of urine. Blockage of the enzyme CYP3A, which is responsible for the breakdown of tolterodine, results in a significantly greater amount of tolterodine in blood. When Clarithromycin is given in combination with tolterodine, 1 mg of tolterodine twice a day is recommended in patients who are deficient in CYP2D6 activity.
Clarithromycin interacts with sildenafil, tadalafil, and vardenafil, which are used in the treatment of erectile dysfunction. Clarithromycin inactivates CYP3A enzyme and the use of sildenafil, tadalafil, and vardenafil together with Clarithromycin will result in increased absorption of sildenafil, tadalafil, and vardenafil. The use of Clarithromycin in combination with these drugs is not recommended.
There may be an interaction of Clarithromycin with efavirenz and nevirapine, which are used to treat HIV/AIDS, rifampicin, rifabutin, and rifapentine, which are used to treat bacterial infections. When Clarithromycin is used in combination with these drugs, it will result in an increase in the breakdown of Clarithromycin, thus decreasing the amount of Clarithromycin in the blood. A different treatment with antibacterials should be initiated in patients who are on treatment with these drugs which are inducers of CYP3A.
Clarithromycin may interact with colchicine, which is used to treat gout characterized by severe pain, redness, and tenderness in joints. When Clarithromycin is given in combination with colchicine, the maximum amount of drug in the blood (Cmax) is increased as well as the exposure of the body to the drug (AUC) is increased to a greater extent. When Clarithromycin is prescribed in combination with colchicine to patients with normal functioning of kidneys and liver, the dose of colchicine should be reduced. This combination should not be given to patients who have kidney or liver problems.
This page does not contain all the possible interactions of Clarithromycin. Share a list of all medicines that you use with your doctor and pharmacist. Do not start, stop, or change the dose of any medicines without the approval of your doctor.

Traveling With Medication

  • Ensure that you carry enough doses of each of your prescription medicines to last the entire trip. The best place to store your medicines is in the carry on baggage. However, while flying, if carrying liquid medicines, make sure you do not go over the limits imposed for carry-on liquids.
  • While traveling overseas, make sure that you can carry each of your prescription medicines legally to your destination country. One way to ensure this is by checking with your destination country's embassy or website.
  • Make sure that you carry each of your medicines in their original packaging, which should typically include your name and address, and the details of the prescribing doctor.
  • If your travel involves crossing time zones, and you are required to take your medicine as per a fixed schedule, make sure that you adjust for the change in time.

Expired Medication

Taking a single dose of expired Clarithromycin is unlikely to cause a side-effect. However, please discuss with your doctor or pharmacist, if you feel unwell or sick. An expired medicine may become ineffective in treating your prescribed conditions. To be on the safe side, it is important not to use an expired drug. You are much safer by always keeping a fresh supply of unexpired medicines.

Safe Disposal of Medication

  • If there are disposal instructions on the package, please follow the instructions.
  • If there are medicine take-back programs in your country, you should contact the respective authority to arrange for the disposal of the medicine. For example, in the USA, the Drug Enforcement Administration regularly hosts National Prescription Drug Take-Back events.
  • If there are no take-back programs, mix the medicine with dirt and place them in a sealed plastic bag. Throw the plastic bag in your household trash. Separately, remove all personal information including the prescription label from the medicine packaging and then dispose off the container.
  • If specifically indicated on the medicine package that it needs to be flushed down the toilet when no longer needed, perform the required step.

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