Drug Index

Clarithromycin

 
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Mechanism :

Clarithromycin is a macrolide antibiotic.
It is first metabolized to 14-OH clarithromycin, which is active and works synergistically with its parent compound. Like other macrolides, it then penetrates bacteria cell wall and reversibly binds to domain V of the 23S ribosomal RNA of the 50S subunit of the bacterial ribosome, blocking translocation of aminoacyl transfer-RNA and polypeptide synthesis. Clarithromycin also inhibits the hepatic microsomal CYP3A4 isoenzyme and P-glycoprotein, an energy-dependent drug efflux pump.


Indication :

• Pertussis

• Mycobacterium avium complex

• Community acquired pneumonia, sinusitis, bronchitis, skin infections

• Mycoplasma pneumonia


Contraindications :

Contraindicated in patients with known hypersensitivity to clarithromycin, or any other macrolide.


Dosing :

15 mg/kg/day PO in 2 divided doses for 7-10 days. Maximum dose: 500 mg/dose.


Adverse Effect :

Nausea, vomiting, abdominal pain, diarrhea, anorexia, altered taste sensation, stomatitis, glossitis, anxiety, dizziness, insomnia, altered liver function tests.


Interaction :

Theophylline: Increase in serum theophylline levels and potential theophylline toxicity.
Oral anticoagulants: Increased anticoagulant effects
Ergotamine or Dihydroergotamine: Acute ergot toxicity characterized by severe peripheral vasospasm and dysesthesia.
Terfenadine, Astemizole and Cisapride: Risk of cardiac arrhythmias.



Renal Dose :

Dose in Renal Impairment GFR (mL/min)
30-50Dose as in normal renal function
10-30Oral: 250–500 mg every 12 hours. IV: 250–500 mg every 12 hours
<10Oral: 250–500 mg every 12 hours. IV: 250–500 mg every 12 hours.

Dose in Patients undergoing Renal Replacement Therapies
CAPDUnknown dialysability. Dose as in GFR<10 mL/min
HDDialysed. Dose as in GFR<10 mL/ min
HDF/High fluxDialysed. Dose as in GFR<10 mL/ min
CAV/VVHDUnknown dialysability. Dose as in GFR=10–30 mL/min

Hepatic Dose :

No dosage adjustments are recommended.
05/19/2020 15:18:56 Clarithromycin
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