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Klacid

Generic Name: Clarithromycin
Product Name: Klacid

Indication

Used for the treatment of mild to moderately severe infections caused by pathogens susceptible to clarithromycin.

Including: acute streptococcal pharyngitis, acute exacerbations of chronic bronchitis, community acquired pneumonia, uncomplicated skin and skin structure infections, atypical mycobacterial infection, acute otitis media.

Action

Clarithromycin is a semi-synthetic macrolide antibiotic with activity against a variety of bacteria responsible for respiratory tract in skin & skin structure infections.

Pharmacokinetics.

Clarithromycinsâ??s absolute bioavailability following oral administration is 50%. The rate and extent of absorption of the tablets is increased by food intake half an hour before dosing, though this is not necessarily replicated in dosing with the oral powder for liquid.
Peak serum concentrations are achieved within 2 hours of oral dosing, with steady state serum concentrations achieved in 2-3 days.
Elimination half life is about 3-4 hours for doses of 250 mg twice daily, though increases to 5-7 hours for does of 500 mg twice daily.
Clarithromycin exhibits mildly non-linear pharmacokinetics at standard doses (250-500 mg), though the extent of non-linearity increases with higher doses.
Clarithromycin is metabolised by isoenzymes of the cytochrome P450 CYP3A4 family to its microbiological active, chief metabolite, 14-OH clarithromycin. If other drugs metabolised by enzymes in this family are administered concomitantly, the likelihood of drug interactions is increased.
20-30% of the dose is excreted in the urine unchanged, a further 10-15% is excreted in the urine as the principle metabolite.

Dose advice

Children < 12 years. Safety and efficacy has not been established.

Non-Mycobacterial infections.
250 mg (up to 500mg), twice daily, for 7-14 days.
L.pneumophilia infections require a dose of 500 mg, twice daily, for 4 weeks.

Paediatric patients (<12 years).
Klacid powder for oral liquid (125 mg/5 mL): 7.5 mg/kg (max 500 mg), twice a day, for 5-10 days (streptococcal pharyngitis treatment should be for 10 days).
For the treatment of mycobacterial infections: 15-30 mg/kg/day, in two divided doses.

Peptic ulcer.
H.pylori eradication: 500 mg, twice daily (concomitantly with Amoxicillin 1 mg twice daily and Omeprazole 20 mg twice daily), for 7-10 days.

Atypical Mycobacterial infection (e.g. M.avium complex): 500mg, twice daily. Increase to 1 mg twice daily in the absence of clinical or bacteriological response after 3-4 weeks. (Clarithromycin should be used in conjunction with other antimycobacterial agents).
Mycobacterial prophylaxis (e.g. HIV patients with CD 4 lymphocyte counts < 75 cells/mm3): 500 mg, twice daily. Should prophylaxis fail, at least two other non-macrolide antimycobacterial agents should be chosen empirically.

Patients with renal impairment.
In adults and children with creatinine clearance < 30 mL/min, dose should be halved (i.e. 250 mg once or twice daily), and not continued for more than 14 days.

Schedule

S4

Common side effects

Headache, dizziness
Nausea, vomiting, diarrhoea, constipation.
Fever, infection, rhinitis, pharyngitis.
Rash, itch.
Increased liver enzymes (transaminases)

Uncommon side effects

Chest pain, back pain.
Sleep disturbance, tremor, flushing.
Photophobia.
Bleeding gums, taste disturbance.

 

For further information talk to your doctor.

Dates

Posted On: 22 July, 2003
Modified On: 22 July, 2003


Created by: myVMC