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clarithromycin

Generic Name: clarithromycin (kla RITH roe MYE sin)
Brand Names: Biaxin, Biaxin XL, Biaxin XL-Pak

What is clarithromycin?

Clarithromycin is in a group of drugs called macrolide antibiotics. Clarithromycin fights bacteria in your body.

Clarithromycin is used to treat many different types of bacterial infections affecting the skin and respiratory system. Clarithromycin is also used together with other medicines to treat stomach ulcers caused by Helicobacter pylori.

Clarithromycin may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about clarithromycin?

Do not use clarithromycin if you are also using any of the drugs listed below. They can interact with clarithromycin and cause life-threatening heart rhythm disorders:

cisapride (Propulsid);
pimozide (Orap); or
ergot medicine such as ergotamine (Ergomar, Ergostat, Cafergot, Ercaf, Wigraine), or dihydroergotamine (D.H.E. 45, Migranal Nasal Spray).

Take this medication for the entire length of time prescribed by your doctor. Clarithromycin is usually given for 7 to 14 days (or longer when treating stomach ulcer). Your symptoms may get better before the infection is completely treated. Clarithromycin will not treat a viral infection such as the common cold or flu.

What should I discuss with my healthcare provider before taking clarithromycin?

Do not use this medication if you are allergic to clarithromycin or to similar medicines such as azithromycin (Zithromax), dirithromycin (Dynabac), erythromycin (E.E.S., E-Mycin, Ery-Tab, Erythrocin), or troleandomycin (Tao). Do not use clarithromycin if you are also using any of the drugs listed below. They can interact with clarithromycin and cause life-threatening heart rhythm disorders:

cisapride (Propulsid);
pimozide (Orap); or
ergot medicine such as ergotamine (Ergomar, Ergostat, Cafergot, Ercaf, Wigraine), or dihydroergotamine (D.H.E. 45, Migranal Nasal Spray).

If you have any of these other conditions, you may need a dose adjustment or special tests to safely take clarithromycin:

liver disease;
kidney disease;
myasthenia gravis;
porphyria; or
a personal or family history of "Long QT syndrome."

FDA pregnancy category C. It is not known whether clarithromycin is harmful to an unborn baby. Before taking this medication, tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether clarithromycin passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. Do not give this medicine to a child younger than 6 months of age.

How should I take clarithromycin?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

Take this medication with a full glass (8 ounces) of water.

Clarithromycin tablets and oral suspension (liquid) can be taken with or without food.

Clarithromycin extended-release tablets (Biaxin XL) should be taken with food Do not crush, chew, or break an extended-release tablet. Swallow the pill whole. It is specially made to release medicine slowly in the body. Breaking the pill would cause too much of the drug to be released at one time. Shake the oral suspension well just before you measure a dose. To be sure you get the correct dose, measure the liquid with a marked measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one. Take this medication for the entire length of time prescribed by your doctor. Clarithromycin is usually given for 7 to 14 days (or longer when treating stomach ulcer). Your symptoms may get better before the infection is completely treated. Clarithromycin will not treat a viral infection such as the common cold or flu. Store this medication at room temperature away from moisture and heat. Do not keep the oral liquid in a refrigerator.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine.

Overdose symptoms may include nausea, vomiting, diarrhea, and abdominal discomfort.

What should I avoid while taking clarithromycin?

Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or has blood in it, call your doctor. Do not use any medicine to stop the diarrhea unless your doctor has told you to.

Clarithromycin side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have any of these serious side effects:

uneven heartbeats, chest pain, shortness of breath;
diarrhea that is watery or bloody;
nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
fever, sore throat, and headache with a severe blistering, peeling, and red skin rash; or
problems with your hearing.

Less serious side effects may include:

mild stomach pain, nausea, vomiting, diarrhea, upset stomach;
unusual or unpleasant taste in your mouth;
tooth discoloration;
dizziness, headache, anxiety, confusion;
skin rash; or
vaginal itching or discharge.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Clarithromycin Dosing Information

Usual Adult Dose for Sinusitis:

clarithromycin 500 mg orally every 12 hours for 14 days
or
clarithromycin XL tablets 1000 mg every 24 hours for 14 days

Usual Adult Dose for Helicobacter pylori Infection:

500 mg orally 3 times a day for 14 days.

Usual Adult Dose for Bronchitis:

clarithromycin 500 mg orally every 12 hours for 7 to 14 days
or
clarithromycin XL tablets 1000 mg orally every 24 hours for 7 days.

The initial dosages recommended for this patient with H. parainfluenzae bronchitis are:
clarithromycin 500 mg orally every 12 hours for 7 days
or
clarithromycin XL tablets 1000 mg orally every 24 hours for 7 days.

The initial dosages recommended for this patient with M. catarrhalis or S. pneumoniae bronchitis are:
clarithromycin 250 mg orally every 12 hours for 7 to 14 days
or
clarithromycin XL tablets 1000 mg orally every 24 hours for 7 days.

Usual Adult Dose for Bacterial Endocarditis Prophylaxis:

500 mg orally one hour before the procedure.

Usual Adult Dose for Legionella Pneumonia:

250 to 500 mg orally every 12 hours. Therapy should be continued for approximately 14 days, depending on the nature and severity of the infection.

Usual Adult Dose for Mycoplasma Pneumonia:

250 to 500 mg orally every 12 hours. Therapy should be continued for approximately 7 to 14 days depending on the nature and severity of the infection.

Usual Adult Dose for Skin or Soft Tissue Infection:

250 to 500 mg orally every 12 hours. Therapy should be continued for approximately 7 to 14 days depending on the nature and severity of the infection.

Usual Adult Dose for Nongonococcal Urethritis:

250 to 500 mg orally every 12 hours. Therapy should be continued for approximately 3 to 7 days, depending on the nature and severity of the infection.

Usual Adult Dose for Mycobacterium avium-intracellulare -- Prophylaxis:

500 mg orally every 12 hours. Therapy is usually required indefinitely, depending on this patient's tolerance of clarithromycin and immune status.

Usual Adult Dose for Mycobacterium avium-intracellulare -- Treatment:

500 mg orally every 12 hours. The duration of therapy for unresectable pulmonary infiltrates is generally 18 to 24 months for the treatment of pulmonary MAI and at least 12 months after sputum conversion. The duration of therapy for disseminated MAI is generally lifelong (as long as a clinical and microbiological response is documented).

Usual Adult Dose for Toxoplasmosis:

1 gram orally every 12 hours. Therapy should be continued for approximately 3 to 6 weeks, depending on the nature and severity of the infection. After completion of treatment, patients should begin life-long suppressive therapy with an appropriate agent.

Usual Adult Dose for Otitis Media:

250 to 500 mg orally every 12 hours. If Haemophilus influenzae is a suspected or documented pathogen the 500 mg dose is strongly recommended Therapy should be continued for approximately 10 to 14 days, depending on the nature and severity of the infection.

Usual Adult Dose for Pharyngitis:

250 to 500 mg orally every 12 hours. If Haemophilus influenzae is a suspected or documented pathogen the 500 mg dose is strongly recommended. Therapy should be continued for 10 days.

Usual Adult Dose for Pneumonia:

250 to 500 mg orally every 12 hours. If Haemophilus influenzae is a suspected or documented pathogen the 500 mg dose is strongly recommended. Therapy should be continued for 7 to 14 days for pneumococcal pneumonia and for 14 to 21 days for other infecting organisms. The duration of therapy depends on the nature and severity of the infection.

Usual Adult Dose for Upper Respiratory Tract Infection:

250 to 500 mg orally every 12 hours. If Haemophilus influenzae is a suspected or documented pathogen the 500 mg dose is strongly recommended. Therapy should be continued for approximately 7 to 14 days, depending on the nature and severity of the infection.

What other drugs will affect clarithromycin?

Before taking clarithromycin, tell your doctor if you are using any of the following drugs:

a blood thinner such as warfarin (Coumadin);
omeprazole (Prilosec);
fluconazole (Diflucan);
ranitidine bismuth citrate (Tritec);
sildenafil (Viagra);
theophylline (Respbid, Theo-Dur, Theoclear, Theochron, Uniphyl);
cholesterol-lowering medicines such as lovastatin (Mevacor), simvastatin (Zocor), pravastatin (Pravachol), fluvastatin (Lescol), or atorvastatin (Lipitor);
drugs that weaken your immune system, such as cyclosporine (Neoral, Sandimmune, Gengraf), sirolimus (Rapamune), tacrolimus (Prograf), or steroids;
heart rhythm medicine such as digoxin (digitalis, Lanoxicaps, Lanoxin), disopyramide (Norpace), or quinidine (Cardioquin, Quinaglute);
HIV medicines such as ritonavir (Norvir) or zidovudine (Retrovir);
a sedative such as alprazolam (Xanax), midazolam (Versed), or triazolam (Halcion); or
seizure medications such as carbamazepine (Carbatrol, Tegretol), phenytoin (Dilantin), and valproic acid (Depakote, Depakene).

This list is not complete and there are many other medicines that can interact with clarithromycin. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. Keep a list with you of all the medicines you use and show this list to any doctor or other healthcare provider who treats you.

Where can I get more information?

Your pharmacist can provide more information about clarithromycin.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.