Medicine Information

Kilbac

Name: Kilbac
Brand: Kilbac

Oral Suspension125 mg/5 mlAntibioticsATC: J01FA09

Generic Name

Clarithromycin 125 mg/5 ml Suspension

Manufacturer

Square Pharmaceuticals Ltd.

Country

Bangladesh

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Price Details

Current market pricing information

Variant	Unit Price	Strip Price
kilbac 125 mg suspension	৳ 230.00	N/A

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 infections. It works by inhibiting bacterial protein synthesis.

Uses & Indications

Upper and lower respiratory tract infections (e.g., pharyngitis, sinusitis, bronchitis, pneumonia)

Skin and soft tissue infections

Mycobacterial infections (e.g., MAC)

Helicobacter pylori eradication (in combination with other drugs)

Otitis media

Dosage

Adults

For children, typically 7.5 mg/kg body weight twice daily (every 12 hours) for 5-14 days, depending on the infection. For 125 mg/5 ml suspension, this means 0.3 mL/kg twice daily. Adults usually require higher strengths (250-500 mg tablets).

Elderly

Similar to adult dosage, but caution with renal impairment.

Renal_impairment

Dosage adjustment is recommended in patients with severe renal impairment (creatinine clearance < 30 mL/min). Dose should be halved or dosing interval doubled.

How to Take

Oral administration. Can be taken with or without food. For best absorption, some recommend taking with food, but it's not strictly necessary. Shake well before use. Use the provided measuring device.

Mechanism of Action

Clarithromycin binds to the 50S ribosomal subunit of susceptible bacteria, thereby inhibiting protein synthesis. This action is generally bacteriostatic, but can be bactericidal at higher concentrations against highly susceptible organisms.

Pharmacokinetics

Onset

2-3 hours to peak plasma concentration.

Excretion

Primarily excreted in urine (20-40% as unchanged drug) and feces (via bile).

Half life

Approximately 3-7 hours for clarithromycin; 5-9 hours for 14-hydroxy clarithromycin (active metabolite).

Absorption

Rapidly absorbed from the gastrointestinal tract, but subject to first-pass metabolism. Bioavailability is approximately 50-55%. Food may delay absorption but does not affect the extent.

Metabolism

Extensively metabolized in the liver by the cytochrome P450 system (CYP3A4) to its active metabolite, 14-hydroxy clarithromycin.

Side Effects

Contraindications

Hypersensitivity to clarithromycin or other macrolide antibiotics
History of cholestatic jaundice/hepatic dysfunction associated with clarithromycin
Co-administration with cisapride, pimozide, astemizole, terfenadine, ergotamine, dihydroergotamine due to risk of QT prolongation and cardiac arrhythmias
Severe hepatic impairment with concomitant renal impairment

Drug Interactions

Digoxin

Increased digoxin levels and toxicity.

Warfarin

Increased anticoagulant effect and risk of bleeding.

Colchicine

Increased colchicine toxicity.

Oral contraceptives

May reduce efficacy of contraceptives (rare).

Statins (e.g., simvastatin, lovastatin)

Increased risk of myopathy/rhabdomyolysis due to increased statin levels.

Benzodiazepines (e.g., midazolam, alprazolam)

Increased sedation and prolonged effects.

QT prolonging drugs (e.g., antiarrhythmics, antipsychotics)

Increased risk of QT prolongation.

Storage

Store dry powder below 30°C. Protect from light and moisture. After reconstitution, store at room temperature (15-30°C) and discard unused portion after 14 days. Do not refrigerate.

Overdose

Symptoms include gastrointestinal upset (nausea, vomiting, diarrhea, abdominal pain). Management is supportive and symptomatic, including gastric lavage and close monitoring of vital signs and ECG for QT prolongation.

Pregnancy & Lactation

Pregnancy Category C: Should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is excreted in human milk; use with caution during lactation, or consider alternatives.

Side Effects

Contraindications

Hypersensitivity to clarithromycin or other macrolide antibiotics
History of cholestatic jaundice/hepatic dysfunction associated with clarithromycin
Co-administration with cisapride, pimozide, astemizole, terfenadine, ergotamine, dihydroergotamine due to risk of QT prolongation and cardiac arrhythmias
Severe hepatic impairment with concomitant renal impairment

Drug Interactions

Digoxin

Increased digoxin levels and toxicity.

Warfarin

Increased anticoagulant effect and risk of bleeding.

Colchicine

Increased colchicine toxicity.

Oral contraceptives

May reduce efficacy of contraceptives (rare).

Statins (e.g., simvastatin, lovastatin)

Increased risk of myopathy/rhabdomyolysis due to increased statin levels.

Benzodiazepines (e.g., midazolam, alprazolam)

Increased sedation and prolonged effects.

QT prolonging drugs (e.g., antiarrhythmics, antipsychotics)

Increased risk of QT prolongation.

Storage

Store dry powder below 30°C. Protect from light and moisture. After reconstitution, store at room temperature (15-30°C) and discard unused portion after 14 days. Do not refrigerate.

Overdose

Pregnancy & Lactation

Frequently Asked Questions

Common questions about this medicine

Pack Sizes

60 ml suspension100 ml suspension

Shelf Life

24 months (unreconstituted powder); 14 days after reconstitution (stored at room temperature).

Availability

Pharmacies nationwide

Approval Status

Approved by regulatory authorities

Patent Status

Generic available

WHO Essential Medicine

Yes

Clinical Trials

Extensively studied in various bacterial infections, demonstrating efficacy and safety profiles across different age groups. Ongoing studies explore its anti-inflammatory and immunomodulatory effects.

Lab Monitoring

Liver function tests (LFTs) in patients with pre-existing hepatic impairment or prolonged therapy.
Renal function tests in patients with renal impairment.
ECG monitoring in patients at risk for QT prolongation or with co-administered QT prolonging drugs.

Doctor Notes

Advise patients to complete the full course of treatment.
Counsel on potential drug interactions, especially with statins, warfarin, and drugs prolonging the QT interval.
Monitor liver and renal function in susceptible patients.
Educate parents/caregivers on proper reconstitution and administration of suspension.

Patient Guidelines

Complete the full course of antibiotics, even if symptoms improve, to prevent resistance.
Shake the suspension well before each use.
Use the provided measuring spoon or cup for accurate dosing.
Report any severe or persistent side effects to your doctor.
Do not share this medicine with others.

Missed Dose Advice

If a dose is missed, take it as soon as remembered. If it is almost time for the next dose, skip the missed dose and resume the regular dosing schedule. Do not double the dose.

Driving Precautions

May cause dizziness, confusion, or visual disturbances. Patients should be advised to exercise caution before driving or operating machinery until they are reasonably certain that clarithromycin does not adversely affect them.