Clix
Generic Name
Clarithromycin
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| clix 500 mg tablet | ৳ 40.00 | ৳ 240.00 |
Description
Overview of the medicine
Clarithromycin is a macrolide antibiotic used to treat various bacterial infections, including respiratory tract infections, skin infections, and Helicobacter pylori eradication.
Uses & Indications
Dosage
Adults
500 mg twice daily for 7 to 14 days, depending on infection type and severity. For H. pylori eradication, typically 500 mg twice daily as part of a triple therapy regimen.
Elderly
No specific dose adjustment required unless severe renal impairment. Careful monitoring is advised.
Renal_impairment
For creatinine clearance <30 mL/min, the dose should be halved or dosing interval doubled (e.g., 250 mg once daily or 500 mg every other day).
How to Take
Clix-500 mg tablets can be taken with or without food. Swallow the tablet whole; do not crush, chew, or break it. Take at evenly spaced intervals.
Mechanism of Action
Inhibits bacterial protein synthesis by binding to the 50S ribosomal subunit, thereby stopping bacterial growth.
Pharmacokinetics
Onset
Within 2 hours.
Excretion
Primarily through urine (20-40%) and feces (30-40%).
Half life
Approximately 3-7 hours for the parent drug (Clarithromycin) and 5-9 hours for the active metabolite (14-hydroxyclarithromycin) with a 500 mg dose.
Absorption
Rapidly absorbed from the gastrointestinal tract; absolute bioavailability is about 50-55%. Peak plasma concentrations are reached within 2-3 hours.
Metabolism
Primarily hepatic, via cytochrome P450 3A (CYP3A), to its active metabolite 14-hydroxyclarithromycin.
Side Effects
Contraindications
- Hypersensitivity to clarithromycin, erythromycin, or any other macrolide antibiotics.
- Concomitant use with cisapride, pimozide, astemizole, terfenadine, ergotamine, or dihydroergotamine due to risk of serious cardiac arrhythmias.
- Severe hepatic impairment in combination with renal impairment.
- Patients with history of QT prolongation or ventricular arrhythmia, including Torsades de Pointes.
Drug Interactions
Digoxin
Increased serum digoxin levels, leading to potential toxicity. Monitor digoxin levels.
Warfarin
Potentiation of anticoagulant effect, leading to increased bleeding risk. Close monitoring of INR is required.
Colchicine
Increased exposure to colchicine, significantly increasing risk of toxicity, especially in renal/hepatic impairment. Avoid concomitant use.
Oral Hypoglycemics/Insulin
Can potentiate hypoglycemic effects; monitor blood glucose levels closely.
Statins (e.g., simvastatin, lovastatin)
Increased risk of myopathy/rhabdomyolysis due to strong CYP3A inhibition by clarithromycin. Avoid concomitant use; if unavoidable, use lower doses of statins metabolized by other pathways (e.g., pravastatin).
CYP3A4 substrates (e.g., carbamazepine, sildenafil, tacrolimus)
Increased plasma concentrations of these drugs, requiring dose adjustment and monitoring.
Storage
Store below 30°C in a dry place, protected from light and moisture. Keep out of reach of children.
Overdose
Overdose of clarithromycin can lead to gastrointestinal symptoms such as abdominal pain, nausea, vomiting, and diarrhea. Management involves gastric lavage and supportive measures. Hemodialysis and peritoneal dialysis are not significantly effective in removing clarithromycin.
Pregnancy & Lactation
Pregnancy Category C. Clarithromycin should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is excreted in human milk; therefore, caution should be exercised when administered to a nursing woman.
Side Effects
Contraindications
- Hypersensitivity to clarithromycin, erythromycin, or any other macrolide antibiotics.
- Concomitant use with cisapride, pimozide, astemizole, terfenadine, ergotamine, or dihydroergotamine due to risk of serious cardiac arrhythmias.
- Severe hepatic impairment in combination with renal impairment.
- Patients with history of QT prolongation or ventricular arrhythmia, including Torsades de Pointes.
Drug Interactions
Digoxin
Increased serum digoxin levels, leading to potential toxicity. Monitor digoxin levels.
Warfarin
Potentiation of anticoagulant effect, leading to increased bleeding risk. Close monitoring of INR is required.
Colchicine
Increased exposure to colchicine, significantly increasing risk of toxicity, especially in renal/hepatic impairment. Avoid concomitant use.
Oral Hypoglycemics/Insulin
Can potentiate hypoglycemic effects; monitor blood glucose levels closely.
Statins (e.g., simvastatin, lovastatin)
Increased risk of myopathy/rhabdomyolysis due to strong CYP3A inhibition by clarithromycin. Avoid concomitant use; if unavoidable, use lower doses of statins metabolized by other pathways (e.g., pravastatin).
CYP3A4 substrates (e.g., carbamazepine, sildenafil, tacrolimus)
Increased plasma concentrations of these drugs, requiring dose adjustment and monitoring.
Storage
Store below 30°C in a dry place, protected from light and moisture. Keep out of reach of children.
Overdose
Overdose of clarithromycin can lead to gastrointestinal symptoms such as abdominal pain, nausea, vomiting, and diarrhea. Management involves gastric lavage and supportive measures. Hemodialysis and peritoneal dialysis are not significantly effective in removing clarithromycin.
Pregnancy & Lactation
Pregnancy Category C. Clarithromycin should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It 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
3 years from the date of manufacture when stored under recommended conditions.
Availability
Pharmacies nationwide
Approval Status
Approved by DGDA
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Clarithromycin has undergone extensive clinical trials demonstrating its efficacy and safety for various bacterial infections, including those of the respiratory tract, skin, and Helicobacter pylori eradication. Post-marketing surveillance continues to monitor its long-term effects.
Lab Monitoring
- Liver function tests (in patients with pre-existing hepatic impairment or during prolonged treatment)
- Renal function tests (in patients with renal impairment)
- Prothrombin time/INR (in patients on concomitant warfarin therapy)
- ECG monitoring (in patients with cardiac risk factors or on concomitant QT-prolonging drugs)
Doctor Notes
- Be mindful of significant drug-drug interactions, particularly with statins (simvastatin, lovastatin), warfarin, digoxin, and colchicine. Dose adjustments or alternative therapies may be necessary.
- Monitor patients for signs of QT prolongation, especially those with pre-existing cardiac conditions, electrolyte imbalances, or concomitant use of other QT-prolonging drugs.
- Advise patients to complete the full course of treatment to prevent resistance, even if symptoms improve early.
Patient Guidelines
- Complete the full course of antibiotic as prescribed by your doctor, even if symptoms improve.
- Do not stop taking the medicine suddenly without consulting your doctor.
- Report any severe or persistent side effects to your doctor immediately.
- Inform your doctor about all other medications, herbal supplements, and over-the-counter drugs you are taking.
Missed Dose Advice
If you miss a dose, take it as soon as you remember, unless it is almost time for your next dose. In that case, 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. If you experience these symptoms, avoid driving or operating heavy machinery.
Lifestyle Advice
- Maintain good hygiene to prevent spread of infection.
- Stay hydrated by drinking plenty of fluids, especially if experiencing diarrhea.
- Avoid consuming alcohol during the treatment period as it may worsen side effects.
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