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Clarithromycin: Brands, Price & Uses in Bangladesh
Clarithromycin is a macrolide antibiotic used to treat a range of bacterial infections.
About Clarithromycin
Indications of Clarithromycin
Clarithromycin is a macrolide antibiotic used to treat a range of bacterial infections. Its indications can be classified by strength of evidence as follows:
Established / FDA-approved uses
- Acute bacterial exacerbation of chronic bronchitis
- Community-acquired pneumonia (mild to moderate)
- Acute maxillary sinusitis
- Pharyngitis and tonsillitis (as an alternative in penicillin-allergic patients)
- Uncomplicated skin and skin-structure infections
- Acute otitis media in children
- Mycobacterium avium complex (MAC) disease - treatment and prevention, in HIV-infected and other immunocompromised patients
Uses requiring combination therapy
- Helicobacter pylori eradication in patients with active or past duodenal ulcer disease, given together with a proton pump inhibitor (e.g. omeprazole or lansoprazole) and amoxicillin (triple therapy)
Guideline-supported / commonly used off-label uses
- Odontogenic (dental) infections, as an alternative agent
- Component of combination regimens for non-tuberculous mycobacterial infections other than MAC
Clarithromycin should be used only for infections proven or strongly suspected to be caused by susceptible bacteria, as directed by a physician.
Dosage & Administration of Clarithromycin
Dosage of Clarithromycin depends on the infection being treated, patient age, and renal/hepatic function. The following is a general guide; the prescribing physician's instructions should always be followed.
| Indication | Adult dose | Typical duration |
|---|---|---|
| Acute bacterial bronchitis exacerbation | 250-500 mg every 12 hours | 7-14 days |
| Community-acquired pneumonia | 250 mg every 12 hours | 7-14 days |
| Acute sinusitis | 500 mg every 12 hours | 14 days |
| Pharyngitis / tonsillitis | 250 mg every 12 hours | 10 days |
| Skin and skin-structure infections | 250 mg every 12 hours | 7-14 days |
| H. pylori eradication (triple therapy) | 500 mg every 12 hours with a proton pump inhibitor and amoxicillin | 10-14 days |
| MAC disease (treatment/prophylaxis) | 500 mg every 12 hours (as part of combination therapy) | As directed; often prolonged |
Pediatric dosing
For children able to take oral suspension: 15 mg/kg/day in two divided doses (every 12 hours), usually for 10 days, up to a maximum of 500 mg per dose, depending on indication.
Renal impairment
In patients with creatinine clearance below 30 mL/min, the dose or dosing frequency should be reduced (commonly by half), as directed by the physician.
Hepatic impairment
Use with caution; dose adjustment may be required, particularly when renal function is also impaired.
Important: Take Clarithromycin exactly as prescribed by your physician; do not stop, extend, skip doses, or share this medicine with others without medical advice, even if symptoms improve before the course is finished.
Side Effects of Clarithromycin
As with all medicines, Clarithromycin can cause side effects, though not everyone experiences them.
Common side effects
- Nausea, vomiting, abdominal pain
- Diarrhea
- Altered taste (metallic or bitter taste - dysgeusia)
- Headache
Less common side effects
- Stomatitis, glossitis, oral candidiasis
- Dizziness, insomnia, anxiety
- Skin rash
Serious side effects (seek medical attention promptly)
- Signs of an allergic reaction: rash, hives, swelling of the face/throat, difficulty breathing
- Signs of liver problems: yellowing of skin/eyes, dark urine, severe fatigue, loss of appetite
- Severe or persistent diarrhea (possible Clostridioides difficile-associated diarrhea)
- Palpitations, fainting, or irregular heartbeat (possible QT prolongation/arrhythmia)
- Muscle pain, tenderness, or weakness (possible rhabdomyolysis, especially with statins)
Rare postmarketing reports include tooth/tongue discoloration, hearing loss (usually reversible), and psychiatric disturbances.
Contraindications of Clarithromycin
Clarithromycin is contraindicated in the following situations:
- Known hypersensitivity to Clarithromycin, erythromycin, or any macrolide antibiotic
- History of cholestatic jaundice or hepatic dysfunction associated with previous use of Clarithromycin
- Concurrent use with cisapride, pimozide, lurasidone, or lomitapide
- Concurrent use with ergot alkaloids (e.g. ergotamine, dihydroergotamine)
- Concurrent use with lovastatin or simvastatin
- Concurrent use with colchicine in patients with renal or hepatic impairment
- Concurrent use with drugs highly dependent on CYP3A4 for clearance where elevated levels are associated with serious or life-threatening events
Frequently Asked Questions about Clarithromycin
What is Clarithromycin used for?
Clarithromycin is a macrolide antibiotic used to treat bacterial infections such as bronchitis, pneumonia, sinusitis, throat infections, skin infections, and, in combination with other medicines, H. pylori-related stomach ulcers. It only works against bacterial infections, not viral illnesses like the common cold or flu.
Can I stop taking Clarithromycin once I feel better?
No. You should take Clarithromycin exactly as prescribed by your physician and complete the full course, even if you start feeling better. Stopping early, skipping doses, or sharing this medicine with others without medical advice can allow the infection to return and contributes to antibiotic resistance.
Can Clarithromycin be taken with statins like simvastatin?
Clarithromycin should not be taken with simvastatin or lovastatin, as it can raise their blood levels significantly and increase the risk of serious muscle damage (rhabdomyolysis). Other statins may require dose adjustment. Always tell your physician about all medicines you take before starting Clarithromycin.
Is Clarithromycin safe during pregnancy or breastfeeding?
Clarithromycin is not recommended during pregnancy except when no alternative treatment is suitable, and only if a physician determines the benefit outweighs the potential risk to the fetus. Small amounts pass into breast milk, so breastfeeding mothers should use Clarithromycin only under medical advice, with the infant monitored for side effects.
What side effects should I watch for with Clarithromycin?
Common side effects of Clarithromycin include nausea, diarrhea, abdominal pain, and an altered or bitter taste in the mouth. Seek prompt medical attention for signs of an allergic reaction, yellowing of the skin/eyes, severe or persistent diarrhea, or an irregular/fast heartbeat, as these can indicate serious reactions such as liver problems, C. difficile colitis, or heart rhythm disturbances.
What should I do if I miss a dose or take too much Clarithromycin?
If you miss a dose of Clarithromycin, take it as soon as you remember unless it is almost time for the next dose - do not double the dose. If you or someone else has taken more Clarithromycin than prescribed, seek immediate medical attention or contact emergency services or a poison control center right away.
Disclaimer
The information provided is accurate to the best of our knowledge, but it does not replace professional medical advice. We cannot guarantee its completeness or accuracy, and the absence of specific information about a drug should not be taken as an endorsement. We are not responsible for any consequences arising from this information, so please consult a healthcare professional for any concerns or questions.