Claritrox

Clarithromycin

URTI eg, strep pharyngitis/tonsillitis, acute maxillary sinusitis; lower resp tract infections eg, bronchitis, pneumonia; acute otitis media; skin & skin structure infections eg, impetigo, folliculitis, cellulitis, abscesses. Granules for oral susp: Disseminated or localized mycobacterial infections due to Mycobacterium avium or Mycobacterium intracellulare. Localized infections due to Mycobacterium chelonae, Mycobacterium fortuitum or Mycobacterium kansasii.

FC tab Adult 250 mg every 12 hr for 7 days. Severe infections 500 mg every 12 hr for 14 days. Renal impairment ½ adult dose. Ped patient <12 yr Granules for oral susp Non-mycobacterial infections 7.5 mg/kg bd up to max: 500 mg bd for 5-10 days. Granules for oral susp 125 mg/5 mL Childn 30-40 kg 10 mL bd, 20-29 kg 7.5 mL bd, 12-19 kg 5 mL bd, 8-11 kg 2.5 mL bd, <8 kg approx 7.5 mg/kg bd. Mycobacterial infections 7.5-15 mg/kg bd up to max: 500 mg bd. Granules for oral susp 250 mg/5 mL Childn 30-40 kg 5 mL bd, 20-29 kg 3.75 mL bd, 12-19 kg 2.5 mL bd, 8-11 kg 1.25 mL bd, <8 kg approx 7.5 mg/kg bd. Mycobacterial infections 15-30 mg/kg daily in 2 divided doses. CrCl <30 mL/min/1.73 m² Reduce to ½ ie, 250 mg once daily. More severe infections 250 mg bd. Duration: Not to exceed 14 days.

May be taken with or without food: Granules for oral susp: May be taken w/ milk.

Hypersensitivity to clarithromycin, erythromycin or any macrolides. Concomitant use w/ cisapride, pimozide, terfenadine, astemizole & ergot derivatives/alkaloids (eg, ergotamine or dihydroergotamine), domperidone. Granules for oral susp: History of congenital or documented acquired QT prolongation or ventricular cardiac arrhythmia including Torsade de pointes; electrolyte disturbances eg, hypokalemia or hypomagnesaemia. Concomitant use w/ oral midazolam, HMG-CoA reductase inhibitors (eg, lovastatin or simvastatin), colchicine, ticagrelor or ranolazine, lomitapide. Severe hepatic failure w/ renal impairment.

Hypersensitivity to erythromycin & other macrolides. Discontinue use if severe acute hypersensitivity reactions occur. Cross-resistance & -sensitivity. Pseudomembranous colitis; superinfection. Long-term use. Hepatic & moderate to severe renal impairment. Pregnancy & lactation. Granules for oral susp: Discontinue use if signs & symptoms of hepatitis occur. Clostridium difficile-associated diarrhea; CAD, severe cardiac insufficiency, conduction disturbances or clinically relevant bradycardia. Monitor for signs & symptoms of myopathy; glucose levels. Perform sensitivity testing for community-acquired pneumonia, skin & soft tissue infections. Not to be taken by patients w/ fructose intolerance, glucose-galactose malabsorption or sucrase-isomaltase insufficiency. Concomitant use w/ triazolobenzodiazepines eg, triazolam, midazolam; drugs associated w/ QT prolongation; hydroxychloroquine or chloroquine; CYP3A4 inducers; other statins; oral hypoglycemic agents (eg, sulphonylureas), insulin; warfarin, direct-acting oral anticoagulants eg, dabigatran, rivaroxaban, apixaban. May affect ability to drive & use machines.

Diarrhoea, nausea, dyspepsia, abdominal pain/discomfort, headache. FC tab: Abnormal taste. Granules for oral susp: Insomnia; dysgeusia, perversion; vomiting; abnormal LFTs; rash, hyperhidrosis.

Increased plasma conc of cisapride, pimozide, carbamazepine, terfenadine, astemizole, domperidone, digoxin, phenytoin, theophylline, valproate, omeprazole. Decreased serum conc of rifabutin or rifampicin. Acute ergot toxicity w/ ergotamine or dihydroergotamine. CNS effects w/ triazolam. Decreased zidovudine steady-state conc. FC tab: Elevated serum conc of cyclosporine, tacrolimus, hexobarbital, alfentanil, quinidine/disopyramide, lovastatin, bromocriptine & other CYP450-metabolised drugs. Potentiated warfarin effects. Increased plasma conc w/ Maalox, ranitidine. Granules for oral susp: Increased AUC of midazolam, alprazolam, triazolam; atazanavir. Increased plasma conc of simvastatin; tolterodine; itraconazole; verapamil, amlodipine, diltiazem. Markedly increased transaminases w/ lomitapide. Increased risk of CV events & mortality w/ hydroxychloroquine or chloroquine. Reduced efficacy w/ rifampicin, phenobarb, St. John's wort. Accelerated metabolism w/ efavirenz, nevirapine, rifapentine. Decreased exposure by etravirine. Increased mean C_min & AUC w/ fluconazole. Increased C_max, C_min & AUC w/ ritonavir, saquinavir. Torsade de pointes w/ quinidine or disopyramide. Hypoglycemia w/ nateglinide, repaglinide or insulin. High risk of bleeding w/ direct-acting oral anticoagulants eg, rivaroxaban, apixaban. Increased exposure of sildenafil, tadalafil, vardenafil. Increased exposure to colchicine.

Macrolides

J01FA09 - clarithromycin ; Belongs to the class of macrolides. Used in the systemic treatment of infections.

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