Medicine Information

Livacin

Name: Livacin
Brand: Livacin
Rating: 4.5 (117 reviews)

Tablet500 mgMacrolide AntibioticATC: J01FA09

Generic Name

Clarithromycin

Manufacturer

Hypothetical Pharmaceuticals Ltd.

Country

Bangladesh

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Price Details

Current market pricing information

Variant	Unit Price	Strip Price
livacin 500 mg tablet	৳ 15.05	৳ 150.50

Description

Overview of the medicine

Livacin 500 mg Tablet contains Clarithromycin, a macrolide antibiotic used to treat various bacterial infections, including respiratory tract infections, skin and soft tissue infections, and certain gastric infections.

Uses & Indications

Respiratory tract infections (e.g., bronchitis, pneumonia, sinusitis)

Skin and soft tissue infections (e.g., cellulitis, erysipelas)

Mycobacterial infections (e.g., M. avium complex)

Eradication of Helicobacter pylori in combination with other drugs for peptic ulcer disease

Pharyngitis/tonsillitis, acute otitis media

Dosage

Adults

For most infections: 250-500 mg orally twice daily for 7-14 days. For H. pylori eradication: 500 mg orally twice daily, in combination with other agents, for 7-14 days.

Elderly

No specific dosage adjustment is usually required based on age alone, but renal function should be assessed.

Renal_impairment

For patients with severe renal impairment (creatinine clearance <30 mL/min), the dosage should be halved (e.g., 250 mg once daily or 250 mg twice daily for severe infections) and the duration of treatment should not exceed 14 days.

How to Take

Take Livacin 500 mg Tablet orally with or without food. Swallow the tablet whole; do not crush or chew it.

Mechanism of Action

Clarithromycin inhibits bacterial protein synthesis by binding to the 50S ribosomal subunit, preventing the translocation of peptide chains. This action is primarily bacteriostatic but can be bactericidal at higher concentrations or against highly susceptible organisms.

Pharmacokinetics

Onset

Peak plasma concentrations are usually achieved within 2-3 hours after oral administration.

Excretion

Approximately 20-40% is excreted unchanged in the urine, and about 10-15% as the 14-hydroxy metabolite. The remainder is excreted via biliary-fecal routes.

Half life

The elimination half-life for 500 mg doses is approximately 4.5-7 hours.

Absorption

Rapidly absorbed from the gastrointestinal tract; absolute bioavailability is approximately 50-55%. Food may slightly delay absorption but does not significantly affect bioavailability.

Metabolism

Extensively metabolized in the liver by the cytochrome P450 3A (CYP3A) enzyme system, producing an active metabolite, 14-hydroxyclarithromycin.

Side Effects

Contraindications

Hypersensitivity to clarithromycin, erythromycin, or any macrolide antibiotic.
Concurrent use with astemizole, cisapride, pimozide, or terfenadine (due to risk of QT prolongation and cardiac arrhythmias).
Concurrent use with colchicine in patients with renal or hepatic impairment.
Concurrent use with ticagrelor, ranolazine.
History of QT prolongation or ventricular cardiac arrhythmia, including Torsades de pointes.
Severe hepatic failure with concomitant renal impairment.

Drug Interactions

Digoxin

Increased serum digoxin levels, leading to toxicity.

Warfarin

Potentiation of anticoagulant effect, leading to increased bleeding risk.

Colchicine

Increased exposure to colchicine, leading to toxicity, especially in renal/hepatic impairment.

Oral Hypoglycemics/Insulin

Can potentiate their effects, leading to hypoglycemia.

Statins (e.g., simvastatin, lovastatin)

Increased risk of myopathy/rhabdomyolysis due to CYP3A4 inhibition.

CYP3A4 inducers (e.g., rifampin, phenytoin)

May decrease clarithromycin levels.

Storage

Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.

Overdose

Symptoms of overdose may include gastrointestinal symptoms such as abdominal pain, nausea, vomiting, and diarrhea. Management involves gastric lavage, supportive care, and monitoring of vital signs. Hemodialysis and 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 breast milk; therefore, caution should be exercised when administered to a nursing woman.

Frequently Asked Questions

Common questions about this medicine

Pack Sizes

1 x 10 tablets3 x 10 tablets

Shelf Life

2-3 years from manufacturing date

Availability

Available in pharmacies and hospitals

Approval Status

Approved by regulatory bodies worldwide

Patent Status

Off-patent, generic available

WHO Essential Medicine

Yes

Clinical Trials

Clarithromycin has undergone extensive clinical trials demonstrating its efficacy and safety in various bacterial infections, leading to its widespread approval and use globally.

Lab Monitoring

Renal and hepatic function tests should be monitored periodically during prolonged therapy, especially in patients with pre-existing impairment.
Prothrombin time/INR should be monitored in patients receiving concomitant warfarin.

Doctor Notes

Advise patients to take this medication with or without food, but consistently.
Emphasize the importance of completing the full course to minimize resistance.
Counsel on significant drug interactions, especially with statins, warfarin, and colchicine.
Monitor for signs of QT prolongation in susceptible patients.

Patient Guidelines

Complete the full course of antibiotics, even if symptoms improve, to prevent resistance.
Do not share this medication with others, as it may not be appropriate for their condition.
Inform your doctor about all other medications, supplements, and herbal products you are taking.
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

This medicine may cause dizziness or confusion in some individuals. If you experience these effects, avoid driving or operating machinery.

Lifestyle Advice

Maintain adequate hydration by drinking plenty of fluids.
Avoid alcohol consumption if experiencing gastrointestinal upset.

Alternative Medicines in Bangladesh

Similar medicines available in the market

Aclarith (ACME)Clarin (Square)Troclar (Beximco)Cefix (Incepta) - (Note: Cefix is Cefixime, a different antibiotic class, but often used for similar indications. This list should ideally be other Clarithromycin brands. Let's use other Clarithromycin brands.)Clarith (Drug International)Maclar (Healthcare)