Precautions while using Clarithromycin 500mg

Clarithromycin 500mg is an antibiotic that inhibits the growth of bacteria. The following is basic information about uses, dosages, precautions when using the drug,...

Clarithromycin 500mg is a macrolide antibiotic. Each film-coated tablet contains 500mg of Clarithromycin and excipients. Clarithromycin is available as a film-coated tablet. Packing is: Box of 1 blister x 10 tablets; box of 2 blisters x 10 tablets or box of 10 blisters x 10 tablets.

2.1. Indications to use Clarithromycin 500mg Clarithromycin is indicated for the treatment of diseases in adults and children 12 years of age and older. The drug is used to treat infections caused by susceptible bacteria. Specifically:
Upper respiratory tract infections: Including diseases such as sinusitis, pharyngitis; Lower respiratory tract infections: Pneumonia, acute and chronic bronchitis; Respiratory tract infections acquired from the community; Skin and soft tissue infections (mild to moderate); Clarithromycin can be used in combination with a proton pump inhibitor such as lansoprazole or omeprazole to treat Helicobacter pylori infection in patients with peptic ulcer disease. 2.2. Contraindications to the use of Clarithromycin 500mg The drug Clarithromycin 500mg is contraindicated in the following cases:
Patients with a history of hypersensitivity to Clarithromycin, its components or other macrolide antibiotics; Patients with hypokalemia ; Patients with renal failure combined with liver failure; Patients with creatinine clearance <30ml/min. No dose adjustment is possible for Clarithromycin 500mg tablets in patients with severe renal impairment; Do not combine clarithromycin with ergotamine or dihydroergotamine because it can cause ergot poisoning; Concomitant use of clarithromycin with cisapride, astemizol, pimozide and terfenadine may cause cardiac arrhythmias, prolongation of the QT interval. Do not use the drug in patients with a history of prolonged QT interval or ventricular arrhythmias; Concomitant use of clarithromycin with HMG-CoA inhibitors (statins) metabolized by CYP3A4 (including simvastatin or lovastatin) may increase the risk of myopathy, rhabdomyolysis. If these drugs are being used, treatment should be discontinued while clarithromycin is being used; Clarithromycin should not be used in patients taking colchicine because it is a strong inhibitor of CYP3A4.

Use Clarithromycin 500mg orally. Dosage is as follows:
3.1. For adults and children from 12 years of age and older Treatment of infections of the respiratory tract, skin and soft tissue: Dosage 500mg, 2 times / day for 6-14 days; Treatment of HP in patients with peptic ulcer: Treatment for 6-14 days with the following options: Clarithromycin 500mg (2 times/day) + lansoprazole 30mg (2 times/day) + amoxicillin 1000mg (2 times/day) ); Clarithromycin 500mg (2 times/day) + lansoprazole 30mg (2 times/day) + metronidazole 400mg (2 times/day); Clarithromycin 500mg (2 times/day) + omeprazole 40mg (2 times/day) + amoxicillin 1000mg (2 times/day) or metronidazol 400mg (2 times/day); Clarithromycin 500mg (2 times/day) + amoxicillin 1000mg (2 times/day) + omeprazole 20mg/day; Clarithromycin 500mg (3 times/day) for 14 days, with omeprazole 40mg (1 time/day) for 28 days. 3.2 With other subjects Do not use Clarithromycin 500mg for children under 12 years old; Elderly people can take the same doses as adults; Patients with renal impairment: No dose adjustment is required except in patients with severe renal impairment (creatinine clearance less than 30ml/min); Patients with hepatic impairment: Dosage adjustment of clarithromycin is required.

When using Clarithromycin 500mg, the following precautions should be taken:
Use caution in patients with hepatic or renal impairment; Long-term use of clarithromycin may render the bacteria insensitive to the drug, leading to diarrhea and pseudomembranous colitis. Therefore, it is necessary to monitor and make regular antibiotic maps for appropriate treatment; There have been cases of treatment with clarithromycin associated with severe myasthenia gravis; Colchicine toxicity occurs with concomitant use of clarithromycin, especially in elderly patients. Therefore, when using 2 drugs at the same time, it is necessary to carefully monitor the symptoms of colchicine toxicity; Clarithromycin 500mg should be used with caution in elderly patients, coronary heart disease, heart failure, bradycardia,... or when used with other drugs that prolong the QT interval. Do not administer to patients with prolonged QT interval, ventricular arrhythmias or heart disease; Caution should be exercised when clarithromycin is co-administered with drugs metabolised by CYP3A4 and HMG-CoA reductase inhibitors; Caution should be exercised when clarithromycin is used concomitantly with aminoglycosides and benzodiazepines; Discontinue clarithromycin if there is a serious acute hypersensitivity reaction including: anaphylaxis, toxic epidermal necrolysis, Steven-Johnson syndrome, purpura,...; Caution is advised when prescribing the combination of clarithromycin and statins. Contraindications to the combination of clarithromycin with simvastatin or lovastatin; Concomitant use of clarithromycin and oral hypoglycemic agents (such as sulphonylurea) or insulin may cause hypoglycaemia. Clarithromycin may cause hypoglycemia when used concomitantly with pioglitazone, nateglinide, repaglinide and rosiglitazone. Therefore, when the patient takes the drug, it is necessary to monitor the blood glucose level; Concomitant use of clarithromycin with the anticoagulant warfarin increases the risk of major bleeding, INR and prothrombin time. Therefore, it is necessary to monitor the INR and prothrombin time in patients receiving concomitant clarithromycin with oral anticoagulants; Clarithromycin can cross the placenta. There is no evidence that the drug affects the fetus, but the benefits and risks of taking the drug to pregnant women need to be weighed and careful monitoring is required. In addition, clarithromycin can be transmitted through breast milk, so people who are breastfeeding should be careful when using the drug; The drug can cause dizziness, loss of balance, disorientation, so be careful when taking the drug if you have to drive, operate machinery, ...

Less serious side effects include:
Stomach upset, vomiting and diarrhea; Change in taste, discomfort in the mouth, change in tooth color; Headache ; mild skin itching or rash; Vaginal itching or discharge. Serious side effects that require immediate medical attention include:
Allergic reactions: Difficulty breathing, rash, swelling of the face or lips, tongue, or throat; headache, dizziness, chest pain, fast or pounding heart, trouble breathing, fainting; Watery or bloody diarrhea; fever, swollen glands, body aches, new or worsening flu or cough symptoms; skin rash, easy bruising or bleeding, numbness, muscle pain or weakness, severe itching; confusion, vomiting, swelling, rapid weight gain, urinating more than usual, or urinary retention; Have hearing problems; Serious skin allergies include: Fever, sore throat, burning eyes, swelling of the face or tongue, pain out, red or purple skin rash that spreads, blistering, peeling. Serious liver side effects that need to be reported to a doctor include:
Mild fever, itchy skin; Nausea, loss of appetite, upper abdominal pain; Jaundice or yellow eyes; Dark urine and clay colored stools.

Overdose: Symptoms may include abdominal pain, nausea, vomiting and diarrhea. Patients should immediately call the emergency center for assistance in removing the drug from the stomach,...; Missed dose: If a dose is missed, the patient should take it as soon as possible. If it is almost time for your next dose, skip the missed dose and take your next dose at the scheduled time; Storage: Store Clarithromycin 500mg at a temperature below 30°C, away from direct sunlight and direct sunlight. Medicines should be kept out of reach of children and pets. Clarithromycin 500mg is a medicine used to treat certain diseases caused by bacteria. When taking drugs, patients need to absolutely follow the doctor's instructions on dosage, use time, ... to ensure optimal treatment effect. In the event of serious adverse reactions, patients should notify their doctor immediately.