GENERIC NAME: clarithromycin

BRAND NAME: Biaxin

DRUG CLASS AND MECHANISM: Clarithromycin is a semi- synthetic macrolide antibiotic chemically related to erythromycin. It is effective against a wide variety of bacteria organisms, such as Haemophilus influenzae, Streptococcus pneumoniae, Mycoplasma pneumoniae, Staphylococcus aureus, and mycobacterium avium, and many others.

PRESCRIPTION: yes

GENERIC AVAILABLE: no

PREPARATIONS: Tablets: 250 mg, 500 mg. Suspension: 125 mg per 5 ml teaspoonful, 250 mg per 5 ml teaspoonful.

STORAGE: Tablets and suspension should be stored at room temperature in a tightly closed container. The oral suspension should not be refrigerated.

PRESCRIBED FOR: Clarithromycin is effective against susceptible bacteria causing infections of the middle ear, tonsillitis, throat infections, laryngitis, bronchitis, pneumonia, and skin infections. It is also used in treating infections caused by mycobacterium avium, an organism closely related to the bacteria that causes tuberculosis. Clarithromycin has been used in combination with Prilosec in treating H. Pylori bacteria that causes stomach ulcers.

DOSING: May be taken with or without food.

DRUG INTERACTIONS: Clarithromycin should be avoided by patients known to be allergic to clarithromycin or other chemically similar macrolide antibiotics, such as erythromycin. Clarithromycin can significantly increase blood levels of the active metabolite of terfenadine (Seldane) when these two medications are co-administered. Erythromycin, another macrolide antibiotic structurally similar to clarithromycin, has been known to interact with astemizole (Hismanal), loratadine (Claritin), bromocriptine, warfarin (Coumadin), carbamazepine (Tegretol), cyclosporine, digoxin (Lanoxin), disopyramide (Norpace), ergotamine, lovastatin (Mevacor), phenytoin (Dilantin), theophylline, triazolam (Halcion), and valproate to alter the blood levels of these medicines. Whether clarithromycin can interfere similarly with these medications is not clearly established. Treatment with clarithromycin and other antibiotics can alter normal bacteria flora of the colon and permit overgrowth of C. difficile, a bacteria responsible for pseudomembranous colitis. Patients who develop pseudomembranous colitis as a result of antibiotics treatment can experience diarrhea, abdominal pain, fever, and sometimes even shock. Safe use with children has not been established. It is not habit forming.

PREGNANCY: Safe use in pregnancy has not been established.

SIDE EFFECTS: Clarithromycin is generally well tolerated, side effects are usually mild and transient. Commonly reported side effects include nausea, diarrhea, abnormal taste, dyspepsia, abdominal pain and headache.

Last Editorial Review: 12/31/1997

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