Clarithromycin Disease Interactions
There are 3 disease interactions with clarithromycin:
Pseudomembranous colitis has been reported with most antibacterial agents and may range in severity from mild to life-threatening, with an onset of up to two months following cessation of therapy. Antibiotic therapy can alter the normal flora of the colon and permit overgrowth of Clostridium difficile, whose toxin is believed to be a primary cause of antibiotic-associated colitis. The colitis is usually characterized by severe, persistent diarrhea and severe abdominal cramps, and may be associated with the passage of blood and mucus. The most common culprits are clindamycin, lincomycin, the aminopenicillins (amoxicillin, ampicillin), and the cephalosporins. Therapy with broad-spectrum antibiotics and other agents with significant antibacterial activity should be administered cautiously in patients with a history of gastrointestinal diseases, particularly colitis. There is some evidence that pseudomembranous colitis, if it occurs, may run a more severe course in these patients and that it may be associated with flares in their underlying disease activity. The offending antibiotic(s) should be discontinued if significant diarrhea occurs during therapy. Stool cultures for Clostridium difficile and stool assay for C. difficile toxin may be helpful diagnostically. A large bowel endoscopy may be considered to establish a definitive diagnosis in cases of severe diarrhea.
- Moriarty HJ, Scobie BA "Pseudomembranous colitis in a patient on rifampicin and ethambutol." N Z Med J 04/23/80 (1980): 294-5
- Thomas E, Mehta JB "Pseudomembranous colitis due to oxacillin therapy." South Med J 77 (1984): 532-3
- Harmon T, Burkhart G, Applebaum H "Perforated pseudomembranous colitis in the breast-fed infant." J Pediatr Surg 27 (1992): 744-6
Clarithromycin and its primary, active metabolite are both eliminated by the kidney to some extent. The daily dosage should be halved in patients with severe renal impairment (CrCl < 30 mL/min). Dosage adjustments are usually not necessary in patients with mild to moderate renal impairment, although theoretically, drug accumulation could occur in these patients if they have concomitant liver disease.
- Hardy D, Guay D, Jones R "Clarithromycin, a unique macrolide." Diagn Microbiol Infect Dis 15 (1992): 39-53
- Zuckerman JM, Kaye KM "The newer macrolides: azithromycin and clarithromycin." Infect Dis Clin North Am 9 (1995): 731-45
- Peters D, Clissold S "Clarithromycin: a review of its antimicrobial activity, pharmacokinetic properties and therapeutic potential." Drugs 44 (1992): 117-64
The use of macrolide antibiotics has been reported to exacerbate symptoms of myasthenia gravis and trigger new onset of symptoms of myasthenic syndrome. Limited data suggest presynaptic suppression of acetylcholine release. Therapy with these agents should be administered cautiously in patients with a history of myasthenia gravis.
- May EF, Calvert PC "Aggravation of myasthenia gravis by erythromycin." Ann Neurol 28 (1990): 577-9
- "Product Information. Ery-tab (erythromycin)." Abbott Pharmaceutical, Abbott Park, IL.
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clarithromycin drug Interactions
There are 646 drug interactions with clarithromycin
clarithromycin alcohol/food Interactions
There is 1 alcohol/food interaction with clarithromycin
Drug Interaction Classification
The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.
|Major||Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.|
|Moderate||Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.|
|Minor||Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.|
Do not stop taking any medications without consulting your healthcare provider.
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