Clarithromycin

kla-rith-roe-MYE-sin

Commonly used brand name(s)

In the U.S.

• Biaxin


• Biaxin Filmtab


• Biaxin XL

Available Dosage Forms:

• Powder for Suspension


• Tablet


• Tablet, Extended Release

Therapeutic Class: Antibiotic

Chemical Class: Macrolide

Uses For clarithromycin

Clarithromycin is used to treat bacterial infections in many different parts of the body. It is also used in combination with other medicines to treat duodenal ulcers caused by H. pylori. clarithromycin is also used to prevent and treat Mycobacterium avium complex (MAC) infection.

Clarithromycin belongs to the class of medicines known as macrolide antibiotics. It works by killing bacteria or preventing their growth. However, clarithromycin will not work for colds, flu, or other virus infections.

clarithromycin is available only with your doctor's prescription.

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although this use is not included in product labeling, clarithromycin is used in certain patients with the following medical condition:

• Legionnaires' disease.

Before Using clarithromycin

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For clarithromycin, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to clarithromycin or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of clarithromycin to treat bacterial infections in children younger than 6 months of age, and to prevent and treat Mycobacterium avium complex in children younger than 20 months of age. Safety and efficacy have not been established in these age groups.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of clarithromycin in the elderly. However, elderly patients are more likely to have severe kidney problems, which may require caution and an adjustment in the dose for patients receiving clarithromycin.

Pregnancy

	Pregnancy Category	Explanation
All Trimesters	C	Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking clarithromycin, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using clarithromycin with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

• Astemizole


• Bepridil


• Cisapride


• Colchicine


• Conivaptan


• Dihydroergotamine


• Dronedarone


• Eplerenone


• Ergoloid Mesylates


• Ergonovine


• Ergotamine


• Levomethadyl


• Lovastatin


• Mesoridazine


• Methylergonovine


• Methysergide


• Pimozide


• Posaconazole


• Ranolazine


• Silodosin


• Simvastatin


• Sparfloxacin


• Terfenadine


• Thioridazine


• Tolvaptan


• Ziprasidone

Using clarithromycin with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Abiraterone


• Acecainide


• Ajmaline


• Amiodarone


• Amisulpride


• Amitriptyline


• Amoxapine


• Apomorphine


• Aprepitant


• Aprindine


• Arsenic Trioxide


• Asenapine


• Atazanavir


• Atorvastatin


• Azimilide


• Azithromycin


• Brentuximab Vedotin


• Bretylium


• Cabazitaxel


• Chloral Hydrate


• Chloroquine


• Chlorpromazine


• Ciprofloxacin


• Citalopram


• Clomipramine


• Clozapine


• Crizotinib


• Dasatinib


• Desipramine


• Dibenzepin


• Digoxin


• Disopyramide


• Docetaxel


• Dofetilide


• Dolasetron


• Doxepin


• Droperidol


• Enflurane


• Erythromycin


• Etravirine


• Everolimus


• Fentanyl


• Flecainide


• Fluconazole


• Fluoxetine


• Fluticasone


• Foscarnet


• Gatifloxacin


• Gemifloxacin


• Granisetron


• Halofantrine


• Haloperidol


• Halothane


• Hydroquinidine


• Ibutilide


• Iloperidone


• Imipramine


• Isoflurane


• Isradipine


• Ixabepilone


• Lapatinib


• Levofloxacin


• Lidoflazine


• Lorcainide


• Lumefantrine


• Mefloquine


• Methadone


• Moxifloxacin


• Nifedipine


• Nilotinib


• Norfloxacin


• Nortriptyline


• Octreotide


• Ofloxacin


• Ondansetron


• Oxycodone


• Paliperidone


• Pazopanib


• Pentamidine


• Perflutren Lipid Microsphere


• Pirmenol


• Prajmaline


• Probucol


• Procainamide


• Prochlorperazine


• Promethazine


• Propafenone


• Protriptyline


• Quetiapine


• Quinidine


• Quinine


• Rifabutin


• Risperidone


• Romidepsin


• Rosuvastatin


• Ruxolitinib


• Salmeterol


• Saquinavir


• Sematilide


• Sertindole


• Sirolimus


• Sodium Phosphate


• Sodium Phosphate, Dibasic


• Sodium Phosphate, Monobasic


• Sorafenib


• Sotalol


• Spiramycin


• Sulfamethoxazole


• Sultopride


• Sunitinib


• Tadalafil


• Tamsulosin


• Tedisamil


• Telithromycin


• Temsirolimus


• Tetrabenazine


• Ticagrelor


• Toremifene


• Trifluoperazine


• Trimethoprim


• Trimipramine


• Vandetanib


• Vasopressin


• Vemurafenib


• Venlafaxine


• Vinorelbine


• Voriconazole


• Zidovudine


• Zolmitriptan


• Zotepine

Using clarithromycin with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Acenocoumarol


• Alfentanil


• Alprazolam


• Aripiprazole


• Bromocriptine


• Carbamazepine


• Cilostazol


• Conjugated Estrogens


• Cyclosporine


• Darunavir


• Delavirdine


• Diazepam


• Efavirenz


• Esterified Estrogens


• Estradiol


• Estriol


• Estrone


• Estropipate


• Fesoterodine


• Glipizide


• Glyburide


• Hexobarbital


• Indinavir


• Itraconazole


• Linezolid


• Lopinavir


• Methylprednisolone


• Midazolam


• Nevirapine


• Paroxetine


• Phenytoin


• Pravastatin


• Prednisone


• Repaglinide


• Rifampin


• Rifapentine


• Ritonavir


• Tacrolimus


• Tipranavir


• Tolterodine


• Trazodone


• Triazolam


• Verapamil


• Warfarin

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of clarithromycin. Make sure you tell your doctor if you have any other medical problems, especially:

• Cholestatic jaundice, history of or


• Heart rhythm problems (e.g., arrhythmia, QT prolongation), history of or


• Liver disease, history of—Should not be used in patients with these conditions.

• Diarrhea or


• Heart disease or


• Liver disease or


• Myasthenia gravis (severe muscle weakness)—Use with caution. May make these conditions worse.

• Kidney disease, severe—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

• Porphyria (enzyme problem), history of—Clarithromycin and ranitidine bismuth citrate should not be used in patients with this condition.

Proper Use of clarithromycin

Take clarithromycin only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

You may take clarithromycin with meals or milk or on an empty stomach. However, clarithromycin extended release tablets should be taken with food.

If you are using the extended-release tablets:

• Swallow the tablet whole. Do not break, crush, or chew it.


• While taking the extended-release form of clarithromycin, part of the tablet may pass into your stools. This is normal and is nothing to worry about.

Measure the oral liquid with a marked measuring spoon, syringe, or cup. The average household teaspoon may not hold the right amount of liquid. Shake the bottle of medicine well just before taking each dose.

If you are taking clarithromycin and zidovudine, these medicines should be taken at least 2 hours apart.

Keep using the medicine for the full time of treatment, even if you or your child begin to feel better after the first few doses. Your infection may not clear up if you stop using the medicine too soon.

Dosing

The dose of clarithromycin will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of clarithromycin. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For oral dosage form (extended-release tablets):
  
  • For bacterial infections:
    
    • Adults—1000 milligrams (mg) once a day for 7 to 14 days.
    
    
    • Children—Use and dose must be determined by your doctor.
    
    
  
  
  • For community-acquired pneumonia:
    
    • Adults—1000 milligrams (mg) once a day for 7 days.
    
    
    • Children—Use and dose must be determined by your doctor.
    
    
  
  


• For oral dosage forms (suspension and tablets):
  
  • For bacterial infections:
    
    • Adults—250 to 500 milligrams (mg) every twelve hours for 7 to 14 days.
    
    
    • Children 6 months of age and older—Dose is based on body weight and must be determined by your doctor. The dose is usually 7.5 milligrams (mg) per kilogram (kg) of body weight every twelve hours for 10 days.
    
    
    • Infants younger than 6 months of age—Use and dose must be determined by your doctor.
    
    
  
  
  • For community-acquired pneumonia:
    
    • Adults—250 milligrams (mg) every twelve hours for 7 to 14 days.
    
    
    • Children 6 months of age and older—Dose is based on body weight and must be determined by your doctor. The dose is usually 7.5 milligrams (mg) per kilogram (kg) of body weight every twelve hours for 10 days.
    
    
    • Infants younger than 6 months of age—Use and dose must be determined by your doctor.
    
    
  
  
  • For prevention or treatment of Mycobacterium avium complex (MAC) infection:
    
    • Adults—500 milligrams (mg) two times a day.
    
    
    • Children 20 months of age and older—Dose is based on body weight and must be determined by your doctor. The dose is usually 7.5 milligrams (mg) per kilogram (kg) of body weight, up to 500 mg, two times a day.
    
    
    • Children younger than 20 months of age—Use and dose must be determined by your doctor.
    
    
  
  
  • For treatment of ulcers associated with H. pylori:
    
    • Adults—500 milligrams (mg) two or three times a day for 10 or 14 days, in combination with omeprazole or ranitidine bismuth sulfate; or 500 mg every twelve hours in combination with amoxicillin and lansoprazole for 10 or 14 days.
    
    
    • Children—Use and dose must be determined by your doctor.
    
    
  
  

Missed Dose

If you miss a dose of clarithromycin, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Do not refrigerate or freeze the oral liquid. Throw away any unused mixed medicine after 14 days.

Precautions While Using clarithromycin

It is very important that your doctor check the progress of you or your child at regular visits to make sure clarithromycin is working properly. Blood and urine tests may be needed to check for unwanted effects.

Do not use clarithromycin if you or your child are also using astemizole (Hismanal®), cisapride (Propulsid®), colchicine (Colcrys®), pimozide (Orap®), terfenadine (Seldane®), certain ergot medicines (such as dihydroergotamine, ergotamine, D.H.E. 45®, Ergomar®, Ergostat®, or Migranal®), or certain medicines to lower cholesterol (such as lovastatin, simvastatin, Altocor®, Mevacor®, or Zocor®). Using these medicines together may increase risk for more serious side effects.

If your or your child's symptoms do not improve within a few days, or if they become worse, check with your doctor.

Make sure your doctor knows if you are pregnant or planning to become pregnant. If you become pregnant while using clarithromycin, tell your doctor right away.

Stop using clarithromycin and check with your doctor right away if you or your child have pain or tenderness in the upper stomach; pale stools; dark urine; loss of appetite; nausea; unusual tiredness or weakness; or yellow eyes or skin. These could be symptoms of a serious liver problem.

clarithromycin may cause diarrhea, and in some cases it can be severe. It may occur 2 months or more after you or your child stop taking clarithromycin. Do not take any medicine to treat diarrhea without first checking with your doctor. If you have any questions or if mild diarrhea continues or gets worse, check with your doctor.

clarithromycin may cause serious allergic reactions, including anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Stop using clarithromycin and call your doctor right away if you have a rash; itching; hoarseness; trouble breathing; trouble swallowing; or any swelling of your hands, face, mouth, or throat while you or your child are using clarithromycin.

Serious skin reactions can occur with clarithromycin. Stop using clarithromycin and check with your doctor right away if you have blistering, peeling, or loosening of the skin; red skin lesions; severe acne or skin rash; sores or ulcers on the skin; or fever or chills while you or your child are using clarithromycin.

Make sure any doctor or dentist who treats you knows that you or your child are using clarithromycin. clarithromycin may affect the results of certain medical tests.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

clarithromycin Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Less common

• Cough


• fever or chills


• hoarseness


• lower back or side pain


• painful or difficult urination

Rare

• Abdominal or stomach tenderness


• fever with or without chills


• nausea and vomiting


• severe abdominal or stomach cramps and pain


• shortness of breath


• skin rash and itching


• unusual bleeding or bruising


• watery and severe diarrhea, which may also be bloody


• yellow eyes or skin

Incidence not known

• Abdominal or stomach pain


• anxiety


• black, tarry stools


• blistering, peeling, or loosening of the skin


• blurred vision


• chest pain or discomfort


• clay-colored stools


• confusion about identity, place, and time


• cool, pale skin


• dark urine


• depression


• difficulty with swallowing


• dizziness


• fainting


• fast, pounding, or irregular heartbeat or pulse


• feeling of unreality


• feeling that others are watching you or controlling your behavior


• feeling that others can hear your thoughts


• feeling, seeing, or hearing things that are not there


• hives


• increased hunger


• irregular heartbeat


• joint or muscle pain


• light-colored stools


• loss of appetite


• nightmares


• puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue


• recurrent fainting


• red skin lesions, often with a purple center


• red, irritated eyes


• redness, swelling, or soreness of the tongue


• seizures


• sense of detachment from self or body


• severe mood or mental changes


• shakiness


• slow heartbeat


• slurred speech


• sore throat


• sores, ulcers, or white spots in the mouth or on the lips


• sudden death


• swollen glands


• tightness in the chest


• unpleasant breath odor


• unusual behavior


• unusual tiredness or weakness


• vomiting of blood


• wheezing

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common

• Acid or sour stomach


• belching


• bloated or full feeling


• change in sensation of taste


• diarrhea (mild)


• excess air or gas in the stomach or intestines


• headache


• heartburn


• indigestion


• passing gas


• stomach discomfort, upset, or pain

Incidence not known

• Alterations of sense of smell


• continuing ringing or buzzing or other unexplained noise in the ears


• feeling of constant movement of self or surroundings


• hearing loss


• lightheadedness


• mental depression


• mood or mental changes


• sensation of spinning


• shakiness in the legs, arms, hands, or feet


• skin eruptions


• sleeplessness


• sore mouth or tongue


• swelling or inflammation of the mouth


• taste loss


• tongue discoloration


• tooth discoloration


• trouble sleeping


• unable to sleep


• weight loss

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: clarithromycin side effects (in more detail)

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More clarithromycin resources

• Clarithromycin Side Effects (in more detail)
• Clarithromycin Use in Pregnancy & Breastfeeding
• Drug Images
• Clarithromycin Drug Interactions
• Clarithromycin Support Group
• 53 Reviews for Clarithromycin - Add your own review/rating

• Clarithromycin Prescribing Information (FDA)


• Clarithromycin Professional Patient Advice (Wolters Kluwer)


• Clarithromycin Monograph (AHFS DI)


• Clarithromycin MedFacts Consumer Leaflet (Wolters Kluwer)


• Biaxin Consumer Overview


• Biaxin Prescribing Information (FDA)


• Biaxin XL Extended-Release Tablets MedFacts Consumer Leaflet (Wolters Kluwer)

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