In children, the dosage may also be based on If you are using this medication to treat an infection, continue to take this medication until the full prescribed amount is finished, even if symptoms disappear after a few days. Controlled studies in pregnant women show no evidence of fetal risk.Semisynthetic macrolide antibiotic that reversibly binds to P site of 50S ribosomal subunit of susceptible organisms and may inhibit RNA-dependent protein synthesis by stimulating dissociation of peptidyl t-RNA from ribosomes, thereby inhibiting bacterial growthHighly stable in presence of gastric acid (unlike erythromycin); food delays but does not affect extent of absorptionPeak plasma time: 2-3 hr (immediate release); 5-8 hr (extended release)Distributed widely into most body tissues except central nervous system (CNS)Half-life: Immediate release, 3-7 hr; active metabolite, 5-9 hrRenal clearance: Approximates normal glomerular filtration rate (GFR)Add half the volume of water to the bottle containing granules and shake vigorously, THENTablet or granules may be administered with or without foodTablets: Store at controlled room temperature of 20-25°C (68-77°F); excursions permitted to 15-30°C (59-86°F)Adding plans allows you to compare formulary status to other drugs in the same class.To view formulary information first create a list of plans. 5 Sinusitis (acute): antimicrobial prescribing 6 May 2017 Background Acute sinusitis (also known as rhinosinusitis) is self-limiting and usually triggered by a viral infection of the upper respiratory tract.




Clarithromycin is an antibiotic. informational and educational purposes only.
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Considerations. Do not double the dose to catch up.Store at room temperature away from light and moisture. Compare Clarithromycin vs. Doxycycline, which is better for uses like: Infection, Lyme and Sinus Infections. Indicated for treatment of mild-to-moderate infections caused by susceptible isolates caused by Haemophilus influenzae, Haemophilus parainfluenzae, Moraxella catarrhalis, or Streptococcus pneumoniae.



Indicated for treatment of mild-to-moderate infections caused by susceptible isolates caused by Haemophilus influenzae, Haemophilus parainfluenzae, Moraxella catarrhalis, or Streptococcus pneumoniaeIndicated for the treatment of mild-to-moderate infections caused by susceptible isolates caused by Haemophilus influenzae, Moraxella catarrhalis, or Streptococcus pneumoniaeExtended release: 1000 mg PO once daily for 14 daysIndicated treatment and prophylaxis of mycobacterial infectionsFor treatment of disseminated infection caused by mycobacterium avium complex (MAC); use in combination with other antimycobacterial drugs (eg, ethambutol)Indicated for H pylori eradication when treating patients with active or history of peptic ulcer diseaseAdminister as part of 2- or 3-drug combination regimen with bismuth subsalicylate, amoxicillin, H2 receptor antagonist, or proton pump inhibitorIndicated for the treatment of mild-to-moderate infections caused by susceptible isolates caused by Haemophilus influenzae, Haemophilus parainfluenzae, Moraxella catarrhalis, Mycoplasma pneumoniae, Streptococcus pneumoniae, or Chlamydophila pneumoniaeUsed off-label for treatment of pertussis or for postexposure prophylaxisUsed off-label for bacterial endocarditis prophylaxisCoadministration with atazanavir: Decrease clarithromycin dose by 50%Indicated for treatment of acute otitis media caused by H influenzae, M catarrhalis, or S pneumoniaeBecause of increased resistance to S Pneumoniae and H Influenzae, not routinely recommended as treatment option≥6 months: 15 mg/kg/day PO divided q12hr for 10 days; not to exceed 500 mg/doseIndicated for community-acquired pneumonia caused by Mycoplasma pneumoniae, S pneumoniae, or Chlamydophila pneumoniae ≥3 months: 15 mg/kg/day PO divided q12hr for 10 days; not to exceed 500 mg/dose Indicated for the treatment of mild-to-moderate infections caused by susceptible isolates caused by Haemophilus influenzae, Moraxella catarrhalis, or Streptococcus pneumoniae≥6 months: 15 mg/kg/day PO divided q12hr for 10 days; not to exceed 500 mg/doseIndicated for treatment of mild-to-moderate infections caused by susceptible isolates caused by Haemophilus influenzae, Haemophilus parainfluenzae, Moraxella catarrhalis, or Streptococcus pneumoniae≥6 months: 15 mg/kg/day PO divided q12hr for 10 days; not to exceed 500 mg/doseIndicated for uncomplicated skin and skin structure infection caused by S aureus or S pyogenes≥6 months: 15 mg/kg/day PO divided q12hr for 10 days; not to exceed 250 mg/doseIndicated treatment and prophylaxis of mycobacterial infectionsWhen used for treatment of disseminated infection caused by mycobacterium avium complex (MAC), administer in combination with other antimycobacterial drugs (eg, ethambutol)≥20 months: 7.5 mg/kg PO q12hr; individual dose not to exceed 500 mgIndicated for pharyngitis/tonsillitis caused by susceptible S pyogenes≥6 months: 7.5 mg/kg q12hr for 10 days; individual dose not to exceed 250 mgUsed off-label for bacterial endocarditis prophylaxis15 mg/kg PO 30-60 minutes before procedure; individual dose not to exceed 500 mg Used off-label for treatment of pertussis or for postexposure prophylaxisAdminister only oral suspension or immediate-release tablets to children; do not use extended-releaseBlood and lymphatic system disorders: Thrombocytopenia, agranulocytosisCardiac disorders: Torsades de pointes, ventricular tachycardia, ventricular arrhythmiaEar and labyrinth disorders: Deafness was reported chiefly in elderly women and was usually reversibleGastrointestinal disorders: Pancreatitis acute, tongue discoloration, tooth discolorationHepatobiliary disorders: Hepatic failure, jaundice hepatocellularImmune system disorders: Anaphylactic reaction, angioedemaInfections and infestations: Pseudomembranous colitisInvestigations: Prothrombin time prolonged, white blood cell count decreased, international normalized ratio increased; abnormal urine color has been reported, associated with hepatic failureMetabolism and nutrition disorders: Hypoglycemia has been reported in patients taking oral hypoglycemic agents or insulinMusculoskeletal and connective tissue disorders: Myopathy, rhabdomyolysis was reported and in some of the reports, clarithromycin was administered concomitantly with statins, fibrates, colchicine or allopurinolNervous system disorders: Convulsion, ageusia, parosmia, anosmia, paraesthesia Psychiatric disorders:Psychotic disorder, confusional state, depersonalization, depression, disorientation, manic behavior, hallucination, abnormal behavior, abnormal dreamsRenal and urinary disorders: Nephritis interstitial, renal failureSkin and subcutaneous tissue disorders: Stevens-Johnson syndrome, toxic epidermal necrolysis, acute generalized exanthematous pustulosis, drug rash with eosinophilia and systemic symptoms (DRESS), Henoch-Schonlein purpura, acneOther: Reports of colchicine toxicity, some resulting in death, with concomitant use of clarithromycin and colchicine, especially in the elderly, some of which occurred in patients with renal insufficiencyUse may result in fungal or bacterial superinfectionDecreased survival observed in HIV patients with mycobacterium avium complex treated with clarithromycin doses above maximum recommended dose; maximum recommended dosing should not be exceeded in this population; development of resistance to clarithromycin observed when used as prophylaxis and treatment of MAC infectionCoadministration with pimozide, cisapride, ergotamine, and dihydroergotamineHistory of cholestatic jaundice or hepatic dysfunction associated with previous use of clarithromycinCoadministration with colchicine in patients with renal or hepatic impairmentCoadministration with HMG-CoA reductase inhibitors (statins) that are extensively metabolized by CYP3A4 (lovastatin, simvastatin), due to the increased risk of myopathy, including rhabdomyolysisAcute hypersensitivity reactions; discontinue immediately if severe hypersensitivity reactions occur (eg, anaphylaxis, Stevens-Johnson syndrome, TEN, drug reaction with eosinophilia and systemic symptoms [DRESS] syndrome, Henoch-Schonlein purpura)Associated with QT interval prolongation and infrequent cases of arrhythmias, including torsade de pointes; avoid using with ongoing proarrhythmic conditions (eg, uncorrected hypokalemia or hypomagnesemia), clinically significant bradycardia; patients aged ≥65 yr may be more susceptible to drug-associated QT prolongation (also see Drug Interaction Overview)Hepatic dysfunction, including increased liver enzyme activity and hepatocellular or cholestatic hepatitis, with or without jaundice, have been reported; this may be severe and is usually reversibleDiscontinue clarithromycin immediately if signs and symptoms of hepatitis occur (eg, anorexia, jaundice, dark urine, pruritus, tender abdomen)May increase morbidity among patients with coronary heart disease who received a 2-week course of clarithromycin; in an observational study, this risk became apparent after patients had been followed for ≥1 year; based on this study, the FDA added a warning to the prescribing information (CLARICOR trial; BMJ 2006;332:22-7)Clostridium difficile associated diarrhea reported with use of nearly all antibacterial agents, including clarithromycinNot for use in pregnancy, except when there is no alternative therapy; apprise patient about potential hazard to fetus if pregnancy occurs while in therapyExacerbation of myasthenia gravis or new onset of symptoms reportedBased on findings from animal studies, drug is not recommended for use in pregnant women except in clinical circumstances where no alternative therapy is appropriate; if pregnancy occurs while taking drug, patient should be apprised of potential hazard to fetusLimited data from a small number of published human studies with therapy use during pregnancy are insufficient to inform drug-associated risks of major birth defects, miscarriage, or adverse maternal or fetal outcomesBased on limited human data, clarithromycin and its active metabolite 14-OH clarithromycin are present in human milk at less than 2% of the maternal weight-adjusted dose; in a separate observational study, reported adverse effects on breast-fed children (rash, diarrhea, loss of appetite, somnolence) were comparable to amoxicillin; no data are available to assess effects of clarithromycin or 14-OH clarithromycin on milk productionDevelopment and health benefits of breastfeeding should be considered along with mother’s clinical need for drug and any potential adverse effects on breast-fed child from therapy or from underlying maternal conditionA: Generally acceptable.





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