Clarithromycin 

(kla rith' roe mye sin)

WHY is this medicine prescribed?

Clarithromycin is used to treat certain bacterial infections, such as pneumonia (a lung infection), bronchitis (infection of the tubes leading to the lungs), and infections of the ears, sinuses, skin, and throat. It also is used to treat and prevent disseminated Mycobacterium avium complex (MAC) infection [a type of lung infection that often affects people with human immunodeficiency virus (HIV)]. It is used in combination with other medications to eliminate H. pylori, a bacterium that causes ulcers. Clarithromycin is in a class of medications called macrolide antibiotics. It works by stopping the growth of bacteria. Antibiotics will not kill viruses that can cause colds, flu, or other infections.

HOW should this medicine be used?

Clarithromycin comes as a tablet, an extended-release (long-acting) tablet, and a suspension (liquid) to take by mouth. The regular tablet and liquid are usually taken with or without food every 12 hours (twice a day) for 7 to 14 days. The long-acting tablet is usually taken with food every 24 hours (once a day) for 7 to 14 days. Your doctor may tell you to take clarithromycin for a longer time depending on your condition. Take clarithromycin at around the same time(s) every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take clarithromycin exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Shake the suspension well before each use to mix the medication evenly.

The tablets should be taken with a full glass of water. Swallow the long-acting tablets whole; do not split, chew, or crush them.

You should begin to feel better during the first few days of treatment with clarithromycin. If your symptoms do not improve or get worse, call your doctor.

Take clarithromycin until you finish the prescription, even if you feel better. If you stop taking clarithromycin too soon, or skip doses, your infection may not be completely treated and the bacteria may become resistant to antibiotics.

Are there OTHER USES for this medicine?

Clarithromycin also is used sometimes to treat other types of infections including Lyme disease (an infection that may develop after a person is bitten by a tick), cryptosporidiosis (an infection that causes diarrhea), cat scratch disease (an infection that may develop after a person is bitten or scratched by a cat), Legionnaires' disease, (type of lung infection), and pertussis (whooping cough; a serious infection that can cause severe coughing). It is also sometimes used to prevent heart infection in patients having dental or other procedures. Talk to your doctor about the possible risks of using this medication for your condition.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

What SPECIAL PRECAUTIONS should I follow?

Before taking clarithromycin,

  • tell your doctor and pharmacist if you are allergic to clarithromycin, azithromycin (Zithromax, Zmax), dirithromycin (Dynabac) (not available in the U.S.), erythromycin (E.E.S., E-Mycin, Erythrocin), telithromycin (Ketek), any other medications, or any of the ingredients in clarithromycin tablets or suspension. Ask your pharmacist for a list of the ingredients.
  • tell your doctor if you are taking astemizole (Hismanal) (not available in the U.S.),cisapride (Propulsid), colchicine (Colcrys), dihydroergotamine (DHE 45, Migranal), ergotamine (Ergomar, in Cafergot, in Migergot), lovastatin (Mevacor, in Advicor) pimozide (Orap), simvastatin (Zocor, in Vytorin), or terfenadine (Seldane) (not available in the U.S.). Your doctor will probably tell you not to take clarithromycin if you are taking one or more of these medications.
  • tell your doctor if you have or have ever had prolonged QT interval (a rare heart problem that may cause fainting or irregular heartbeat) or ventricular arrhythmia (abnormal heart rhythms) or if you have ever had jaundice (yellowing of the skin or eyes) or other liver problems while taking clarithromycin, Your doctor will probably tell you not to take clarithromycin.
  • tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: anticoagulants ('blood thinners') such as warfarin (Coumadin); certain benzodiazepines such as alprazolam (Xanax), midazolam (Versed), and triazolam (Halcion); bromocriptine (Parlodel); calcium channel blockers such as amlodipine (Norvasc, in Caduet, in Lotrel), diltiazem (Cardizem, Dilacor, Tiazac), and verapamil (Calan, Covera, Isoptin, Verelan, in Tarka); carbamazepine (Tegretol); certain medications for HIV such as atazanavir (Reyataz), didanosine (Videx), efavirenz (Sustiva, in Atripla), nevirapine (Viramune), nelfinavir (Viracept), ritonavir (Norvir, in Kaletra), saquinavir (Invirase), and zidovudine (AZT, Retrovir); certain medications for irregular heartbeat such as amiodarone (Cordarone, Pacerone), disopyramide (Norpace), dofetilide (Tikosyn), procainamide (Procanbid), quinidine, and sotalol (Betapace); cholesterol-lowering medications (statins) such as atorvastatin (Lipitor, in Caduet) and pravastatin (Pravachol); cilostazol (Pletal); cyclosporine (Neoral, Sandimmune); darifenacin (Enablex); digoxin (Digitek, Lanoxin); erlotinib (Tarceva); eszopiclone (Lunesta); fluconazole (Diflucan); insulin; itraconazole (Sporanox); methylprednisolone (Medrol); omeprazole (Prilosec); oral medications for diabetes such as nateglinide (Starlix), pioglitazone (Actos, in Actoplus Met, in Duetact), repaglinide (Prandin, in Prandimet), and rosiglitazone (Avandia, in Avandamet, in Avandaryl); phenytoin (Dilantin); ranitidine (Zantac); rifabutin (Mycobutin); rifampin (Rifadin, Rifamate, rifampicin, Rimactane); rifapentine (Priftin); sildenafil (Viagra); tacrolimus (Prograf); theophylline (Theo-Dur); tadalafil (Cialis, Adcirca); tolterodine (Detrol); valproate (Depacon); valproic acid (Depakote); vardenafil (Levitra); and vinblastine. Many other medications may also interact with clarithromycin, so tell your doctor about all the medications you are taking, even those that do not appear on this list. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
  • tell your doctor if you have a low level of magnesium or potassium in your blood, or if you have or have ever had an irregular heartbeat, or kidney, or liver disease.
  • tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking clarithromycin, call your doctor.
  • if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking clarithromycin.

What SPECIAL DIETARY instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.

What should I do IF I FORGET to take a dose?

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

What SIDE EFFECTS can this medicine cause?

Clarithromycin may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

  • diarrhea

• nausea

  • vomiting
  • stomach pain
  • heartburn

• gas

  • change in taste
  • headache

Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately or get emergency medical treatment:

• rash

• hives

• itching

  • swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
  • difficulty breathing or swallowing
  • hoarseness
  • peeling or blistering skin

• fever

  • yellowing of the skin or eyes
  • extreme tiredness
  • unusual bleeding or bruising
  • lack of energy
  • loss of appetite
  • pain in the upper right part of the stomach
  • dark-colored urine
  • flu-like symptoms
  • fast, pounding, or irregular heartbeat
  • muscle weakness such as difficulty chewing, talking, or performing daily activities
  • double vision

Clarithromycin may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/Safety/MedWatch ] or by phone [1-800-332-1088].

What should I know about STORAGE and DISPOSAL of this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store the tablets at room temperature and away from light, excess heat, and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Do not refrigerate the suspension. Keep it at room temperature and away from excess heat and moisture. Throw away any unused suspension after 14 days. Talk to your pharmacist about the proper disposal of your medication.

What should I do in case of OVERDOSE?

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Symptoms of overdose may include the following:

  • stomach pain

• nausea

  • vomiting
  • diarrhea

What OTHER INFORMATION should I know?

Keep all appointments with your doctor and the laboratory. Your doctor may order certain lab tests to check your body's response to clarithromycin.

The extended-release tablet does not dissolve in the stomach after swallowing. It slowly releases the medication as it passes through your digestive system. You may notice the tablet coating in the stool. This is normal and does not mean that you did not get the full dose of medication.

Do not let anyone else take your medication. Your prescription is probably not refillable. If you still have symptoms of infection after you finish the clarithromycin, call your doctor.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

Brand Names
  • Biaxin® Filmtab®
  • Biaxin® Granules
  • Biaxin® XL Filmtab
  • Biaxin® XL Pac
  • Prevpac® (as a combination product containing amoxicillin and lansoprazole)

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