Kilbac
Generic Name
Clarithromycin
Manufacturer
General Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| kilbac 500 mg tablet | ৳ 45.00 | ৳ 180.00 |
Description
Overview of the medicine
Kilbac 500 mg Tablet contains Clarithromycin, a macrolide antibiotic used to treat a wide range of bacterial infections including respiratory tract infections, skin and soft tissue infections, and Helicobacter pylori eradication.
Uses & Indications
Dosage
Adults
The usual recommended dose is 250 mg to 500 mg twice daily for 7 to 14 days, depending on the infection. For H. pylori eradication, it is typically 500 mg twice daily as part of a triple therapy regimen.
Elderly
No specific dose adjustment is required in elderly patients with normal renal function. For elderly patients with renal impairment, dose adjustment may be necessary.
Renal_impairment
For patients with severe renal impairment (creatinine clearance < 30 mL/min), the dose should be halved or the dosing interval doubled (e.g., 250 mg once daily or 250 mg twice daily for 7-14 days).
How to Take
Kilbac tablets should be swallowed whole with a glass of water, with or without food. Do not crush or chew the tablet.
Mechanism of Action
Clarithromycin inhibits bacterial protein synthesis by binding to the 50S ribosomal subunit, thereby interfering with translocation of peptides. This action is primarily bacteriostatic but can be bactericidal at higher concentrations or against highly susceptible organisms.
Pharmacokinetics
Onset
Onset of action varies depending on the type and severity of infection, typically within a few hours to days.
Excretion
Excreted through both renal (approximately 20-40%) and biliary (approximately 30%) routes.
Half life
The elimination half-life for clarithromycin (500 mg dose) is approximately 3-7 hours.
Absorption
Rapidly and well absorbed from the gastrointestinal tract after oral administration. Bioavailability is approximately 50-55%.
Metabolism
Extensively metabolized in the liver, primarily by the CYP3A4 enzyme, to its active metabolite 14-hydroxyclarithromycin.
Side Effects
Contraindications
- Hypersensitivity to clarithromycin, other macrolide antibiotics, or any component of the formulation.
- Concomitant administration with cisapride, pimozide, astemizole, terfenadine, ergotamine, or dihydroergotamine due to risk of serious cardiac arrhythmias.
- Concomitant administration with HMG-CoA reductase inhibitors (statins) that are extensively metabolized by CYP3A4 (e.g., simvastatin, lovastatin) due to increased risk of rhabdomyolysis.
- Patients with history of QT prolongation or ventricular cardiac arrhythmia, including Torsades de Pointes.
- Patients with severe hepatic impairment in combination with renal impairment.
Drug Interactions
Warfarin
Increased anticoagulant effect (INR monitoring required).
Ritonavir, Fluconazole
May increase clarithromycin levels.
Statins (Simvastatin, Lovastatin)
Increased risk of myopathy/rhabdomyolysis; concomitant use is contraindicated.
Antiarrhythmics (e.g., Quinidine, Disopyramide)
Increased risk of QT prolongation and ventricular arrhythmias.
Carbamazepine, Cyclosporine, Digoxin, Tacrolimus
Increased plasma concentrations of these drugs.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include abdominal pain, nausea, vomiting, and diarrhea. Management involves gastric lavage to remove unabsorbed drug and supportive symptomatic care. Hemodialysis or peritoneal dialysis are not effective.
Pregnancy & Lactation
Pregnancy Category C. Use 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 mother.
Side Effects
Contraindications
- Hypersensitivity to clarithromycin, other macrolide antibiotics, or any component of the formulation.
- Concomitant administration with cisapride, pimozide, astemizole, terfenadine, ergotamine, or dihydroergotamine due to risk of serious cardiac arrhythmias.
- Concomitant administration with HMG-CoA reductase inhibitors (statins) that are extensively metabolized by CYP3A4 (e.g., simvastatin, lovastatin) due to increased risk of rhabdomyolysis.
- Patients with history of QT prolongation or ventricular cardiac arrhythmia, including Torsades de Pointes.
- Patients with severe hepatic impairment in combination with renal impairment.
Drug Interactions
Warfarin
Increased anticoagulant effect (INR monitoring required).
Ritonavir, Fluconazole
May increase clarithromycin levels.
Statins (Simvastatin, Lovastatin)
Increased risk of myopathy/rhabdomyolysis; concomitant use is contraindicated.
Antiarrhythmics (e.g., Quinidine, Disopyramide)
Increased risk of QT prolongation and ventricular arrhythmias.
Carbamazepine, Cyclosporine, Digoxin, Tacrolimus
Increased plasma concentrations of these drugs.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include abdominal pain, nausea, vomiting, and diarrhea. Management involves gastric lavage to remove unabsorbed drug and supportive symptomatic care. Hemodialysis or peritoneal dialysis are not effective.
Pregnancy & Lactation
Pregnancy Category C. Use 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 mother.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from the date of manufacture, specific details on packaging.
Availability
Pharmacies, Hospitals
Approval Status
Approved by DGDA (Bangladesh)
Patent Status
Off-patent (Generic available)
WHO Essential Medicine
YesClinical Trials
Clarithromycin has undergone extensive clinical trials demonstrating its efficacy and safety in various bacterial infections. Ongoing research continues to explore its role in new indications and resistance patterns.
Lab Monitoring
- Liver function tests (LFTs) should be monitored periodically, especially during prolonged therapy or in patients with pre-existing hepatic impairment.
- Renal function should be monitored in patients with impaired renal function.
Doctor Notes
- Prescribe with caution in patients with pre-existing cardiac conditions due to the risk of QT prolongation.
- Monitor for signs and symptoms of C. difficile-associated diarrhea during and after therapy.
- Advise patients on potential drug interactions, especially with statins and antiarrhythmics.
Patient Guidelines
- Complete the full course of treatment as prescribed by your doctor, even if your symptoms improve.
- Do not share this medicine with others, even if they have similar symptoms.
- Report any severe or persistent side effects to your doctor immediately.
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 take a double dose to make up for a missed one.
Driving Precautions
Kilbac may cause dizziness, confusion, or disorientation in some patients. Patients should be advised to exercise caution when driving or operating machinery until they know how Kilbac affects them.
Lifestyle Advice
- Maintain good hydration by drinking plenty of fluids.
- Practice good hygiene to prevent further spread of infection.
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