Clarithromycin - instructions for use, analogs, reviews and release forms (tablets and capsules 250 mg and 500 mg) of the drug for the treatment of bronchitis, pneumonia, Helicobacter and other infections in adults, children and pregnancy

In this article, you can read the instructions for using the drug Clarithromycin. Presented are reviews of visitors to the site - consumers of this medication, as well as opinions of specialists on the use of the antibiotic Clarithromycin in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Clarithromycin in the presence of existing structural analogues.Use for the treatment of bronchitis, pneumonia, Helicobacter and other infections in adults, children, as well as during pregnancy and lactation.

Clarithromycin - Semisynthetic macrolide antibiotic of broad spectrum of action. The antibacterial effect of clarithromycin is realized by suppressing protein synthesis due to binding to the 50s subunit of bacterial ribosomes. Clarithromycin has a pronounced activity against a wide range of aerobic and anaerobic Gram-positive and Gram-negative organisms. The minimum inhibitory concentration of clarithromycin (MIC) is half that of Erythromycin for most microorganisms.

14-hydroxy-metabolite clarithromycin also has antimicrobial activity. The minimum inhibitory concentrations of this metabolite are equal to or higher than the MIC of clarithromycin; for H. influenzae, 14-hydroxymetabolite is twice as active as clarithromycin.

Pharmacokinetics

Absorption is fast. Food slows down absorption, without significantly affecting bioavailability. The bioavailability of clarithromycin in the form of a suspension is equivalent to or slightly higher than when taken in the form of tablets.It is allocated by the kidneys and with the fecal masses (20-30% - in unchanged form, the rest - in the form of metabolites).

Indications

• infections of the lower respiratory tract (bronchitis, pneumonia);
• infections of the upper respiratory tract (pharyngitis, sinusitis, otitis);
• infections of the skin and soft tissues (folliculitis, erysipelas);
• widespread or localized mycobacterial infections caused by Mycobacterium avium and Mycobacterium intracellulare;
• localized infections caused by Mycobacterium chelonae, Mycobacterium fortuitum and Mycobacterium kansasii;
• elimination of H. pylori and a decrease in the frequency of recurrences of duodenal ulcers.

Forms of release

Tablets 250 mg.

Capsules 250 mg and 500 mg.

Instructions for use and dosage

For adults, the average dose for oral administration is 250 mg twice a day. If necessary, you can prescribe 500 mg 2 times a day. The duration of the course of treatment is 6-14 days.

Children prescribe the drug at a dose of 7.5 mg / kg of body weight per day. The maximum daily dose is 500 mg. The duration of the course of treatment is 7-10 days.

To treat infections caused by Mycobacterium avium, clarithromycin is prescribed by mouth - 1 g 2 times a day. The duration of treatment can be 6 months or more.

In patients with renal insufficiency, with creatinine clearance less than 30 ml / min, the dose of the drug should be reduced by 2 times. The maximum duration of a course in patients of this group should be no more than 14 days.

Side effect

• nausea, vomiting;
• dyspepsia;
• stomach ache;
• diarrhea;
• the development of pseudomembranous colitis, from medium to life-threatening;
• headache;
• a taste disorder;
• loss of hearing;
• discoloration of teeth;
• glossitis;
• stomatitis;
• candidiasis;
• thrombocytopenia, leukopenia;
• hypoglycemia;
• dizziness;
• anxiety;
• fear;
• fear;
• insomnia;
• nightmares;
• noise in ears;
• confusion of consciousness;
• disorientation;
• hallucination;
• psychosis;
• prolongation of the QT interval;
• ventricular arrhythmia, incl. ventricular paroxysmal tachycardia.

Contraindications

• simultaneous reception of ergot derivatives;
• when treating clarithromycin, it is forbidden to take cisapride, pimozide, astemizole and terfenadine; In patients taking these drugs concomitantly with clarithromycin, there is an increase in their concentration in the blood. It is possible to prolong the QT interval and develop cardiac arrhythmias, including ventricular paroxysmal tachycardia, ventricular fibrillation and flutter or ventricular fibrillation;
• severe dysfunction of the liver and / or kidney;
• increased sensitivity to antibiotics from the macrolide group.

Application in pregnancy and lactation

Safety of clarithromycin during pregnancy and lactation is not established. Therefore, during pregnancy clarithromycin is prescribed only in the absence of alternative therapy if the intended benefit exceeds the possible risk to the fetus.

Clarithromycin penetrates into breast milk, so if it is necessary to prescribe the drug during lactation, breastfeeding should be stopped.

special instructions

In the presence of chronic liver diseases it is necessary to carry out regular monitoring of serum enzymes.

Caution is prescribed against the background of drugs metabolized by the liver (it is recommended to measure their concentration in the blood).

In the case of co-administration with Warfarin or other indirect anticoagulants, prothrombin time should be monitored.

With heart disease in the anamnesis, simultaneous administration with terfenadine, cisapride, astemizole is not recommended.

It is necessary to pay attention to the possibility of cross-resistance between clarithromycin and other antibiotics from the macrolide group, as well as Lincomycin and clindamycin.

With prolonged or repeated use of the drug, it is possible to develop superinfection (growth of insensitive bacteria and fungi).

Drug Interactions

With simultaneous administration increases the concentration in the blood of drugs metabolized in the liver with the help of cytochrome P450 enzymes, indirect anticoagulants, carbamazepine, theophylline, astemizole, cisapride, terfenadine (2-3 times), triazolam, midazolam, cyclosporine, disopyramide, phenytoin, rifabutin, Lovastatin, digoxin, ergot alkaloids

It is reported that there are rare cases of acute necrosis of skeletal muscles that coincide in time with simultaneous administration of clarithromycin and inhibitors of GMK-CoA reductase, lovastatin and simvastatin.

There are reports of an increase in the concentration of Digoxin in the plasma of patients receiving both digoxin and clarithromycin tablets. In such patients it is necessary to constantly monitor the serum digoxin content in order to avoid digitalis intoxication.

Clarithromycin can reduce the clearance of triazolam and, thus, increase its pharmacological effects with the development of drowsiness and confusion.

Simultaneous use of clarithromycin and ergotamine (ergot derivative) can lead to acute ergotminic intoxication, manifested by severe peripheral vasospasm and perverted sensitivity.

Simultaneous administration of zidovudine orally to HIV-infected adults and clarithromycin tablets may lead to a decrease in equilibrium concentrations of zidovudine. Given that clarithromycin probably alters the absorption of an orally administered zidovudine, this interaction is largely avoided with the use of clarithromycin and zidovudine at various hours of the day (with an interval of at least 4 hours).

With the simultaneous administration of clarithromycin and ritonavir, the serum concentration of clarithromycin increases. Correction of the dose of clarithromycin in these cases is not required for patients with normal renal function. However, in patients with creatinine clearance from 30 to 60 ml / min, the dose of clarithromycin should be reduced by 50%. When creatinine clearance is less than 30 ml / min, the dose of clarithromycin should be reduced by 75%. With simultaneous treatment with ritonavir, clarithromycin should not be administered at doses greater than 1 g per day.

Analogues of the drug Clarithromycin

Structural analogs for the active substance:

• Arvitsin;
• Arvitsin retard;
• Binocular;
• Zimbactur;
• Kispar;
• Klabaks;
• Clarcat;
• Clarithromycin Pfizer;
• Clarithromycin retard;
• Clarithromycin OBL;
• Clarithromycin Verte;
• Clarithromycin Protech;
• Clarithromycin Teva;
• Clarithrosine;
• Claricin;
• Claricite;
• Claromin;
• Class;
• Clacid;
• The CP clacide;
• Clerimedes;
• Coater;
• Crixan;
• Seidon-Sanovel;
• SR-Clarene;
• Fromromide;
• Fromyloid Uno;
• Ecositrin.

Similar medicines:

Other medicines: