Maclar
Generic Name
Clarithromycin
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| maclar 500 mg tablet | ৳ 40.00 | ৳ 240.00 |
Description
Overview of the medicine
Maclar 500 mg Tablet contains Clarithromycin, a macrolide antibiotic used to treat a wide range of bacterial infections including respiratory tract, skin, and soft tissue infections, and Helicobacter pylori eradication.
Uses & Indications
Dosage
Adults
250-500 mg orally twice daily. For H. pylori eradication, it is usually 500 mg twice daily as part of a multi-drug regimen.
Elderly
Similar to adults; dosage adjustment may be needed for renal impairment.
Renal_impairment
For creatinine clearance <30 mL/min, the dose should be halved or dosing interval doubled (e.g., 250 mg once daily or 250 mg twice daily for severe impairment).
How to Take
Maclar tablets can be taken orally with or without food. Taking with food may reduce gastrointestinal upset.
Mechanism of Action
Clarithromycin inhibits bacterial protein synthesis by binding to the 50S ribosomal subunit, thereby preventing bacterial growth and replication.
Pharmacokinetics
Onset
Peak plasma concentrations achieved within 2-3 hours.
Excretion
Mainly through urine and feces.
Half life
Approximately 3-7 hours, depending on the dose.
Absorption
Rapidly absorbed from the gastrointestinal tract; good oral bioavailability.
Metabolism
Primarily hepatic, via CYP3A4, producing an active metabolite, 14-hydroxyclarithromycin.
Side Effects
Contraindications
- Hypersensitivity to clarithromycin or any macrolide antibiotic.
- Concomitant use with cisapride, pimozide, astemizole, terfenadine (due to risk of QTc prolongation and arrhythmias).
- Severe hepatic impairment in combination with renal impairment.
- History of QTc prolongation or ventricular cardiac arrhythmia.
Drug Interactions
Digoxin
Increased serum digoxin levels and potential for toxicity.
Warfarin
Potentiation of anticoagulant effect, leading to increased INR and bleeding risk.
Statins (e.g., simvastatin, lovastatin)
Increased risk of myopathy and rhabdomyolysis due to inhibition of CYP3A4 by clarithromycin.
QTc-prolonging drugs (e.g., antiarrhythmics, antipsychotics)
Additive effect on QTc interval prolongation, increasing risk of Torsades de Pointes.
CYP3A4 substrates (e.g., carbamazepine, ciclosporin, phenytoin, tacrolimus, theophylline)
Increased plasma concentrations of these drugs, requiring dose adjustment.
Storage
Store below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include gastrointestinal upset and neurological effects. Management should involve gastric lavage and supportive care.
Pregnancy & Lactation
Pregnancy Category C. Should be used during 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 or any macrolide antibiotic.
- Concomitant use with cisapride, pimozide, astemizole, terfenadine (due to risk of QTc prolongation and arrhythmias).
- Severe hepatic impairment in combination with renal impairment.
- History of QTc prolongation or ventricular cardiac arrhythmia.
Drug Interactions
Digoxin
Increased serum digoxin levels and potential for toxicity.
Warfarin
Potentiation of anticoagulant effect, leading to increased INR and bleeding risk.
Statins (e.g., simvastatin, lovastatin)
Increased risk of myopathy and rhabdomyolysis due to inhibition of CYP3A4 by clarithromycin.
QTc-prolonging drugs (e.g., antiarrhythmics, antipsychotics)
Additive effect on QTc interval prolongation, increasing risk of Torsades de Pointes.
CYP3A4 substrates (e.g., carbamazepine, ciclosporin, phenytoin, tacrolimus, theophylline)
Increased plasma concentrations of these drugs, requiring dose adjustment.
Storage
Store below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include gastrointestinal upset and neurological effects. Management should involve gastric lavage and supportive care.
Pregnancy & Lactation
Pregnancy Category C. Should be used during 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
2 years from the date of manufacture.
Availability
Pharmacies, Hospitals
Approval Status
Approved
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have demonstrated the efficacy and safety of clarithromycin for its approved indications. Ongoing research continues to explore its potential in new areas.
Lab Monitoring
- Liver function tests (LFTs) in patients with pre-existing hepatic impairment or prolonged therapy.
- Renal function in patients with renal impairment.
- INR/PT if co-administered with warfarin.
Doctor Notes
- Counsel patients on potential drug interactions, especially with statins, warfarin, and QTc-prolonging agents.
- Monitor liver function and renal function in patients with pre-existing impairment or during prolonged therapy.
- Advise patients to complete the full course to prevent resistance and recurrence.
Patient Guidelines
- Complete the full course of medication as prescribed, even if symptoms improve.
- Do not share this medicine with others.
- Report any severe or persistent side effects to your doctor immediately.
Missed Dose Advice
If a dose is missed, take it as soon as you remember. If it is almost time for the next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose.
Driving Precautions
Clarithromycin may cause dizziness or blurred vision. Patients should be cautioned about operating machinery or driving until they are reasonably certain that clarithromycin does not adversely affect their ability.
Lifestyle Advice
- Maintain good personal hygiene.
- Avoid alcohol consumption if experiencing gastrointestinal upset.
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Global Brand Names
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