Indications

Antibiotic

Contraindication

Patient w/ known hypersensitivity to clarithromycin or any other macrolide antibiotic, history of QT prolongation or ventricular cardiac arrhythmia, including torsades de pointes, hypokalaemia, history of cholestatic jaundice or hepatic dysfunction associated w/ prior use of clarithromycin. Patient receiving terfenadine, astemizole, pimozide, cisapride, ergotamine or dihydroergotamine, and colchicine.

Special Precautions

Patient w/ coronary artery disease, severe cardiac insufficiency, hypomagnesaemia, bradycardia (<50 bpm). May exacerbate symptoms of myasthenia gravis. Renal and hepatic impairment. Pregnancy and lactation. Monitoring Parameters Monitor CBC w/ differential, BUN and creatinine.

Side Effects

Smell and taste disturbances, stomatitis, glossitis, tongue and tooth discolouration, headache, arthralgia, myalgia, hypoglycaemia, leucopenia, thrombocytopenia, interstitial nephritis, muscle weakness, agranulocytosis, elevated serum amylase levels, QT prolongation, torsades de pointes, corneal opacities, fever, pulmonary infiltration w/ eosinophilia, delirium, visual hallucinations, pancreatitis.

Drug Interactions

Reduced efficacy w/ CYP3A inducers (e.g. phenytoin, carbamazepine). Strong inducers of CYP450 system (e.g. efavirenz, rifampicin) may accelerate metabolism, thus lower plasma levels of clarithromycin. Inhibition of metabolism w/ ritonavir. Torsades de pointes may result from concomitant quinidine or disopyramide. Increased phosphodiesterase inhibitor exposure w/ sildenafil, tadalafil or vardenafil. Increased risk of digoxin toxicity. Decreased concentration of zidovudine. Concomitant use w/ atazanavir, itraconazole or saquinavir may result to bi-directional drug interactions. Hypotension, bradyarrhythmias, and lactic acidosis may result when taken w/ verapamil. Increased risk of myopathy, including rhabdomyolysis w/ HMG-CoA reductase inhibitors. Increased risk of hypoglycaemia w/ oral hypoglycaemic drugs (e.g. pioglitazone) and insulin. Risk of serious haemorrhage and elevation of INR and prothrombin time w/ oral anticoagulants. Increased ototoxicity w/ aminoglycosides. Increased and prolonged sedation w/ triabenzodiazepines (e.g. midazolam).

Route of Administration

Oral

Dosage

As directed by the physician