Claricin
Generic Name
claricin-250-mg-tablet
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| claricin 250 mg tablet | ৳ 30.00 | ৳ 120.00 |
Description
Overview of the medicine
Clarithromycin is a macrolide antibiotic used to treat various bacterial infections, including respiratory tract, skin, and soft tissue infections. It is also used in combination therapy for Helicobacter pylori eradication.
Uses & Indications
Dosage
Adults
Usually 250 mg twice daily for 7-14 days, depending on the infection. For Helicobacter pylori eradication, 250-500 mg twice daily, as part of a triple therapy regimen.
Elderly
Similar to adult dosage, but caution is advised in elderly patients with impaired renal function.
Renal_impairment
For creatinine clearance < 30 mL/min, the dose should be halved (e.g., 250 mg once daily) or the dosing interval prolonged.
How to Take
Take orally, with or without food. Swallow the tablet whole; do not crush, break, or chew it.
Mechanism of Action
Clarithromycin inhibits bacterial protein synthesis by binding to the 50S ribosomal subunit of susceptible bacteria, thereby preventing their growth and reproduction.
Pharmacokinetics
Onset
Peak plasma concentrations reached approximately 2-3 hours after oral administration.
Excretion
Primarily via urine and bile, with a significant portion excreted as unchanged drug and its metabolites.
Half life
Approximately 3-7 hours for the 250 mg dose.
Absorption
Well absorbed orally; food may delay the rate but not affect the extent of absorption.
Metabolism
Primarily hepatic via the cytochrome P450 3A4 (CYP3A4) isoenzyme, forming an active metabolite, 14-hydroxyclarithromycin.
Side Effects
Contraindications
- Hypersensitivity to clarithromycin, other macrolide antibiotics, or any component of the formulation.
- Concurrent use with cisapride, pimozide, astemizole, terfenadine, or ergot derivatives (e.g., ergotamine, dihydroergotamine) due to risk of serious cardiac events.
- History of QT prolongation or ventricular arrhythmia, including Torsades de Pointes.
- Severe hepatic and renal impairment concomitantly.
Drug Interactions
Warfarin
Increased anticoagulant effect and risk of bleeding due to elevated INR.
Colchicine
Increased colchicine toxicity, including fatal cases, especially in patients with renal impairment.
Oral Hypoglycemics/Insulin
Risk of significant hypoglycemia.
Carbamazepine, phenytoin, digoxin
Increased plasma concentrations of these drugs, requiring dose adjustment and monitoring.
Statins (e.g., simvastatin, lovastatin)
Increased risk of myopathy and rhabdomyolysis due to inhibition of CYP3A4 by clarithromycin.
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 symptoms such as nausea, vomiting, abdominal pain, and diarrhea. Management involves gastric lavage, supportive care, and close monitoring of vital signs. Hemodialysis and peritoneal dialysis are not effective.
Pregnancy & Lactation
Pregnancy Category C. Use in pregnancy only if the potential benefit justifies the potential risk to the fetus. Clarithromycin is excreted in breast milk; caution should be exercised when administered to a nursing woman.
Side Effects
Contraindications
- Hypersensitivity to clarithromycin, other macrolide antibiotics, or any component of the formulation.
- Concurrent use with cisapride, pimozide, astemizole, terfenadine, or ergot derivatives (e.g., ergotamine, dihydroergotamine) due to risk of serious cardiac events.
- History of QT prolongation or ventricular arrhythmia, including Torsades de Pointes.
- Severe hepatic and renal impairment concomitantly.
Drug Interactions
Warfarin
Increased anticoagulant effect and risk of bleeding due to elevated INR.
Colchicine
Increased colchicine toxicity, including fatal cases, especially in patients with renal impairment.
Oral Hypoglycemics/Insulin
Risk of significant hypoglycemia.
Carbamazepine, phenytoin, digoxin
Increased plasma concentrations of these drugs, requiring dose adjustment and monitoring.
Statins (e.g., simvastatin, lovastatin)
Increased risk of myopathy and rhabdomyolysis due to inhibition of CYP3A4 by clarithromycin.
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 symptoms such as nausea, vomiting, abdominal pain, and diarrhea. Management involves gastric lavage, supportive care, and close monitoring of vital signs. Hemodialysis and peritoneal dialysis are not effective.
Pregnancy & Lactation
Pregnancy Category C. Use in pregnancy only if the potential benefit justifies the potential risk to the fetus. Clarithromycin is excreted in breast milk; caution should be exercised when administered to a nursing woman.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months from the date of manufacture.
Availability
Pharmacies, Hospitals
Approval Status
Approved
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Clarithromycin has undergone extensive clinical trials demonstrating its efficacy and safety across a range of bacterial infections. Ongoing research continues to explore its use and resistance patterns.
Lab Monitoring
- Liver function tests (LFTs) periodically, especially in patients with pre-existing hepatic impairment.
- Renal function monitoring in elderly patients or those with pre-existing renal impairment.
- Prothrombin time/INR for patients on concomitant warfarin therapy.
Doctor Notes
- Emphasize the importance of completing the full course of treatment to prevent therapeutic failure and the emergence of resistant bacteria.
- Counsel patients on potential drug interactions, particularly with statins (simvastatin, lovastatin) and warfarin, and advise on monitoring.
- Advise caution in patients with hepatic or renal impairment, requiring dose adjustment.
Patient Guidelines
- Complete the entire course of medication, even if symptoms improve, to prevent resistance and recurrence.
- Do not share this medicine with others, even if they have similar symptoms.
- Report any severe side effects, persistent diarrhea, or signs of liver problems immediately to your doctor.
- Avoid taking antacids containing aluminum or magnesium within 2 hours of clarithromycin.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not double the dose to catch up.
Driving Precautions
Clarithromycin may cause dizziness, confusion, or visual disturbances in some patients. Patients should be advised to exercise caution when driving or operating machinery until they know how the medicine affects them.
Lifestyle Advice
- Maintain good hydration by drinking plenty of fluids.
- Follow a balanced diet to support overall health.
- Avoid alcohol consumption if it worsens gastrointestinal side effects.
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