Clacin
Generic Name
Clarithromycin
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| clacin 500 mg tablet | ৳ 40.00 | N/A |
Description
Overview of the medicine
Clarithromycin is a macrolide antibiotic used to treat various bacterial infections, including respiratory tract infections, skin and soft tissue infections, and Helicobacter pylori eradication.
Uses & Indications
Dosage
Adults
For most infections, 250 mg to 500 mg orally twice daily for 7 to 14 days. For H. pylori eradication, typically 500 mg twice daily as part of a triple therapy regimen.
Elderly
No specific dose adjustment is usually required based on age alone, but renal function should be assessed and dose adjusted if necessary.
Renal_impairment
For patients with severe renal impairment (creatinine clearance < 30 mL/min), the dosage should be halved, or the dosing interval doubled (e.g., 250 mg once daily or 250 mg twice daily if necessary for severe infections).
How to Take
Clacin-500-mg-tablet should be taken orally. It can be taken with or without food. However, extended-release formulations are usually recommended to be taken with food.
Mechanism of Action
Clarithromycin inhibits bacterial protein synthesis by binding to the 50S ribosomal subunit, preventing the translocation of peptides.
Pharmacokinetics
Onset
Rapid, with antibacterial effects typically observed within hours of administration.
Excretion
Excreted via both urinary and fecal routes. Approximately 20-40% of the parent drug is excreted unchanged in urine, with the remainder excreted as metabolites.
Half life
The elimination half-life for a 500 mg dose is approximately 5-7 hours. The active metabolite, 14-hydroxyclarithromycin, has a half-life of 7-9 hours.
Absorption
Well absorbed from the gastrointestinal tract; food may delay but does not affect the extent of absorption. Peak plasma concentrations are reached in approximately 2-3 hours.
Metabolism
Extensively metabolized in the liver, primarily by the CYP3A4 enzyme, to its active metabolite 14-hydroxyclarithromycin and other inactive metabolites.
Side Effects
Contraindications
- Hypersensitivity to clarithromycin, erythromycin, or any macrolide antibiotic.
- Concomitant administration with cisapride, pimozide, astemizole, terfenadine, ergot derivatives (e.g., ergotamine, dihydroergotamine), or colchicine (in patients with renal or hepatic impairment).
- History of QT prolongation or ventricular arrhythmia, including Torsades de Pointes.
Drug Interactions
Digoxin
May increase serum digoxin concentrations, requiring monitoring and dose adjustment.
Warfarin
Potentiates the anticoagulant effect, leading to an increased risk of bleeding. Close monitoring of INR is required.
Colchicine
Increased exposure to colchicine, especially in renal/hepatic impairment, leading to serious and life-threatening toxicity. Concomitant use is contraindicated.
Other QT-prolonging drugs
Increased risk of cardiac arrhythmias. Avoid concomitant use.
Statins (e.g., simvastatin, lovastatin)
Increased risk of myopathy, including rhabdomyolysis, due to CYP3A4 inhibition by clarithromycin. Co-administration is generally contraindicated or requires dose reduction/temporary discontinuation of statin.
Oral Hypoglycemics (e.g., glibenclamide)
May enhance hypoglycemic effects, requiring blood glucose monitoring.
Storage
Store below 30°C in a dry place, protected from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include gastrointestinal complaints (e.g., nausea, vomiting, abdominal pain) and possible QT prolongation. Management involves gastric lavage and supportive treatment. There is no specific antidote.
Pregnancy & Lactation
Pregnancy Category C. Clarithromycin should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Clarithromycin is excreted in human milk; therefore, caution should be exercised when administered to a nursing woman.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 to 36 months from the date of manufacture, depending on the manufacturer's specification.
Availability
Pharmacies, Hospitals
Approval Status
Approved
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Clarithromycin has undergone extensive clinical trials demonstrating its efficacy and safety across various bacterial infections since its introduction. Ongoing research continues to explore its applications and resistance patterns.
Lab Monitoring
- Liver function tests (LFTs) in patients with pre-existing hepatic impairment or prolonged therapy.
- Renal function tests in elderly patients or those with known renal impairment.
- INR (International Normalized Ratio) in patients receiving concomitant warfarin.
- ECG monitoring for patients at risk of QT prolongation.
Doctor Notes
- Always inquire about concomitant medications, especially statins, warfarin, and other QT-prolonging drugs, due to significant interaction risks.
- Consider dosage adjustment in patients with severe renal impairment.
- Advise patients to report any signs of hepatotoxicity (e.g., jaundice, dark urine) or severe diarrhea.
Patient Guidelines
- Take the medicine exactly as prescribed by your doctor and complete the full course of treatment, even if your symptoms improve.
- Do not share this medicine with others, even if they have similar symptoms.
- Inform your doctor about all other medications you are taking, including over-the-counter drugs and herbal supplements.
- Report any persistent or severe side effects, especially severe diarrhea, to your doctor immediately.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose to catch up.
Driving Precautions
Clarithromycin may cause dizziness or blurred vision in some individuals. Patients should be advised to exercise caution when driving or operating machinery until they know how the medicine affects them.
Lifestyle Advice
- Maintain good personal hygiene to prevent the spread of infection.
- Stay hydrated by drinking plenty of fluids.
- Avoid alcohol consumption during the course of treatment as it may worsen gastrointestinal side effects.
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Global Brand Names
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