Description

Simple

An antibiotic used to treat various bacterial infections in the body, including the skin, ear, and stomach.

Clinical

A macrolide antibiotic used for the treatment of a wide variety of bacterial infections such as acute otitis, pharyngitis, tonsillitis, respiratory tract infections, uncomplicated skin infections, and helicobacter pylori infection.

Overview

Clarithromycin, a semisynthetic macrolide antibiotic derived from erythromycin, inhibits bacterial protein synthesis by binding to the bacterial 50S ribosomal subunit. Binding inhibits peptidyl transferase activity and interferes with amino acid translocation during the translation and protein assembly process. Clarithromycin may be bacteriostatic or bactericidal depending on the organism and drug concentration.

Pharmacology

Indication

An alternative medication for the treatment of acute otitis media caused by H. influenzae, M. catarrhalis, or S. pneumoniae in patients with a history of type I penicillin hypersensitivity. Also for the treatment of pharyngitis and tonsillitis caused by susceptible Streptococcus pyogenes Read more

Pharmacodynamic

Clarithromycin is a macrolide antibiotic whose spectrum of activity includes many gram-positive (Staphylococcus aureus, S. pneumoniae, and S. pyogenes) and gram-negative aerobic bacteria (Haemophilus influenzae, H. parainfluenzae, and Moraxella catarrhalis), many anaerobic bacteria, so... Read more

Mechanism of action

Clarithromycin is first metabolized to 14-OH clarithromycin, which is active and works synergistically with its parent compound. Like other macrolides, it then penetrates bacteria cell wall and reversibly binds to domain V of the 23S ribosomal RNA of the 50S subunit of the bacterial ribosome, blocki... Read more

Absorption

Clarithromycin is well-absorbed, acid stable and may be taken with food.

Protein binding

~ 70% protein bound

Volume of distribution

Information currently not available.

Clearance

Information currently not available.

Half life

3-4 hours

Route of elimination

After a 250 mg tablet every 12 hours, approximately 20% of the dose is excreted in the urine as clarithromycin, while after a 500 mg tablet every 12 hours, the urinary excretion of clarithromycin is somewhat greater, approximately 30%.

Toxicity

Symptoms of toxicity include diarrhea, nausea, abnormal taste, dyspepsia, and abdominal discomfort. Transient hearing loss with high doses has been observed. Pseudomembraneous colitis has been reported with clarithromycin use. Allergic reactions ranging from urticaria and mild skin eruptions to rare... Read more

Adverse Effects

Contraindications

  • Regions: US
  • Patient Conditions:
      • Name: Chlestatic jaundice
      • Drugbank Id: DBCOND0108272
  • With Drugs:
      • Name: Clarithromycin
      • Drugbank Id: DB01211
  • Regions: US
  • Patient Conditions:
      • Name: Hepatic dysfuntion
      • Drugbank Id: DBCOND0108260
  • With Drugs:
      • Name: Clarithromycin
      • Drugbank Id: DB01211
  • Regions: US
  • With Drugs Coadmin:
      • Name: Ergotamine
      • Drugbank Id: DB00696
  • Regions: US
  • With Drugs Coadmin:
      • Name: Dihydroergotamine
      • Drugbank Id: DB00320
  • Regions: US
  • With Drugs Coadmin:
      • Name: Colchicine
      • Drugbank Id: DB01394
  • Regions: US
  • With Categories Coadmin:
      • Name: Hydroxymethylglutaryl-CoA Reductase Inhibitors
      • Drugbank Id: DBCAT000391
      • Mesh Id: D019161
  • Regions: US
  • With Drugs Coadmin:
      • Name: Cisapride
      • Drugbank Id: DB00604
  • Regions: US
  • With Drugs Coadmin:
      • Name: Pimozide
      • Drugbank Id: DB01100

Food Interactions

  • Take with food. Food increases absorption.

Interactions

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  • Paracetamol(acetaminophen)
  • Paxil(paroxetine)
  • Pamelor(nortriptyline)
  • Panadol(acetaminophen)
  • Patanol(olopatadine ophthalmic)
  • Pataday(olopatadine ophthalmic)
  • Parnate(tranylcypromine)
  • Pazeo(olopatadine ophthalmic)
(R)-warfarin
The serum concentration of (R)-warfarin can be increased when it is combined with Clarithromycin.
(S)-Warfarin
The serum concentration of (S)-Warfarin can be increased when it is combined with Clarithromycin.
3-isobutyl-1-methyl-7H-xanthine
The metabolism of 3-isobutyl-1-methyl-7H-xanthine can be decreased when combined with Clarithromycin.
4-hydroxycoumarin
The metabolism of 4-hydroxycoumarin can be decreased when combined with Clarithromycin.
6-O-benzylguanine
The metabolism of 6-O-benzylguanine can be decreased when combined with Clarithromycin.
7-Deazaguanine
The metabolism of 7-Deazaguanine can be decreased when combined with Clarithromycin.
7,9-Dimethylguanine
The metabolism of 7,9-Dimethylguanine can be decreased when combined with Clarithromycin.
8-azaguanine
The metabolism of 8-azaguanine can be decreased when combined with Clarithromycin.
8-chlorotheophylline
The metabolism of 8-chlorotheophylline can be decreased when combined with Clarithromycin.
9-aminocamptothecin
The metabolism of 9-aminocamptothecin can be decreased when combined with Clarithromycin.
9-Deazaguanine
The metabolism of 9-Deazaguanine can be decreased when combined with Clarithromycin.
9-Methylguanine
The metabolism of 9-Methylguanine can be decreased when combined with Clarithromycin.
Abatacept
The metabolism of Clarithromycin can be increased when combined with Abatacept.
Abemaciclib
The metabolism of Abemaciclib can be decreased when combined with Clarithromycin.
Abexinostat
The risk or severity of QTc prolongation can be increased when Clarithromycin is combined with Abexinostat.
Acalabrutinib
The metabolism of Clarithromycin can be decreased when combined with Acalabrutinib.
Acefylline
The metabolism of Acefylline can be decreased when combined with Clarithromycin.
Acenocoumarol
The serum concentration of Acenocoumarol can be increased when it is combined with Clarithromycin.
Aceprometazine
The risk or severity of QTc prolongation can be increased when Clarithromycin is combined with Aceprometazine.
Acetohexamide
The serum concentration of Acetohexamide can be increased when it is combined with Clarithromycin.
6 References
  1. 1 . Malhotra-Kumar S, Lammens C, Coenen S, Van Herck K, Goossens H: Effect of azithromycin and clarithromycin therapy on pharyngeal carriage of macrolide-resistant streptococci in healthy volunteers: a randomised, double-blind, placebo-controlled study. Lancet. 2007 Feb 10;369(9560):482-90.PubMed: 17292768
  2. 2 . Zuckerman JM, Qamar F, Bono BR: Macrolides, ketolides, and glycylcyclines: azithromycin, clarithromycin, telithromycin, tigecycline. Infect Dis Clin North Am. 2009 Dec;23(4):997-1026, ix-x. doi: 10.1016/j.idc.2009.06.013.PubMed: 19909895
  3. 3 . Piscitelli SC, Danziger LH, Rodvold KA: Clarithromycin and azithromycin: new macrolide antibiotics. Clin Pharm. 1992 Feb;11(2):137-52.PubMed: 1312921
  4. 4 . Peters DH, Clissold SP: Clarithromycin. A review of its antimicrobial activity, pharmacokinetic properties and therapeutic potential. Drugs. 1992 Jul;44(1):117-64.PubMed: 1379907
  5. 5 . Authors unspecified: Clarithromycin. Tuberculosis (Edinb). 2008 Mar;88(2):92-5. doi: 10.1016/S1472-9792(08)70005-2.PubMed: 18486039
  6. 6 . Stephenson GA, Stowell JG, Toma PH, Pfeiffer RR, Byrn SR: Solid-state investigations of erythromycin A dihydrate: structure, NMR spectroscopy, and hygroscopicity. J Pharm Sci. 1997 Nov;86(11):1239-44.PubMed: 9383733