Macrolide類 Bronchitis, acute bacterial exacerbation; Helicobacter pylori eradication; Mycobacterial infections; Otitis media; Pharyngitis/tonsillitis ;Skin/skin structure infections

Antibiotic, Macrolide

Bioavailability: ~50% Half-life elimination: Immediate release: Clarithromycin: 3-7 hours; 14-OH-clarithromycin: 5-9 hours

Hypersensitivity to clarithromycin, erythromycin, any of the macrolide antibiotics, or any component of the formulation; history of cholestatic jaundice/hepatic dysfunction associated with prior use of clarithromycin; concomitant use with cisapride, pimozide, ergot alkaloids (eg, ergotamine, dihydroergotamine), or HMG-CoA reductase inhibitors extensively metabolized by CYP3A4 (eg, lovastatin, simvastatin); concomitant use with colchicine in patients with renal or hepatic impairment

C

Clarithromycin and its active metabolite (14-hydroxy clarithromycin) are present in breast milk.

Central nervous system: Headache (2%), insomnia Dermatologic: Skin rash (children 3%) Gastrointestinal: Dysgeusia (adults 3% to 7%), vomiting (children 6%), diarrhea (3% to 6%), nausea (adults 3%), abdominal pain (2% to 3%), dyspepsia (adults 2%) Hematologic & oncologic: Prolonged prothrombin time (adults 1%) Hepatic: Abnormal hepatic function tests Hypersensitivity: Anaphylactoid reaction Infection: Candidiasis (including oral) Renal: Increased blood urea nitrogen (4%)

Usual dosage range: Oral: 250 to 500 mg every 12 hours or 1000 mg (two 500 mg extended-release tablets) once daily for 7 to 14 days

Usual dosage range: Note: All pediatric dosing recommendations based on immediate release product formulations (tablet and oral suspension): Infants ?6 months, Children, and Adolescents: Oral: 7.5 mg/kg every 12 hours (maximum: 500 mg/dose) for 10 days

CrCl ?30 mL/minute: No dosage adjustment necessary. CrCl <30 mL/minute: Decrease clarithromycin dose by 50% Hemodialysis: Administer after HD session is completed (Aronoff 2007). In combination with atazanavir or ritonavir: CrCl 30 to 60 mL/minute: Decrease clarithromycin dose by 50%. CrCl <30 mL/minute: Decrease clarithromycin dose by 75%.

Dosing: Hepatic Impairment: Adult No dosage adjustment necessary if renal function is normal; however, in patients with hepatic impairment and concomitant severe renal impairment, a dosage reduction or prolonged dosing intervals may be appropriate.

Store at 25 degrees C.