Clarithromycin, 14 pcs., 500 mg, film-coated tablets

Clarithromycin, 14 pcs., 500 mg, film-coated tablets

Pharmacodynamics

Clarithromycin is a second-generation bacteriostatic antibiotic from the group of broad-spectrum macrolides. Disturbs the protein synthesis of microorganisms (binds to the 50S subunit of the ribosomal membrane of the microbial cell). Acts on extra- and intracellularly located pathogens. Active regarding:

Streptococcus agalactiae (Streptococcus pyogenes, Streptococcus viridans, Streptococcus pneumoniae), Haemophilus influenzae (parainfluenzae), Haemophilus ducreyi, Neisseria gonorrhoeae, Neisseria meningitidis, Listeria monocytogenes, Legionella pneumophila, Mycoplasma pneumoniae, Helicobacter pylori (Campilobacter), Campi lobacter jejuni, Chlamydia pneumoniae, Moraxella catarrhalis, Bordetella pertussis, Propionibacterium acne, Mycobacterium avium, Mycobacterium leprae, Mycobacterium kansasii, Mycobacterium marinom, Staphylococcus aureus, Ureaplasma urealyticum, Toxoplasma gondii, Corynebacterium spp., Borrelia burgdorferi, Pasteurella multocida, some anaerobes (Eubacterium spp. ., Peptococcus spp., Propionibacterium spp., Clostridium perfringens, Bacteroides melaninogenicus), is less active against Mycobacterium tuberculosis.

Pharmacokinetics

Absorption is fast. Food slows absorption without significantly affecting bioavailability. Communication with plasma proteins is more than 90%. After a single dose, 2 peaks of the maximum concentration of the drug in the blood plasma are recorded. The second peak is due to the ability of the drug to concentrate in the gallbladder, followed by gradual or rapid entry into the intestine and absorption. The time to reach the maximum concentration of the drug in the blood plasma after oral administration of 250 mg is 1-3 hours.

After oral administration, 20% of the dose taken is quickly hydroxylated in the liver by cytochrome enzymes CYP3A4, CYP3A5 and CYP3A7 to form the main metabolite -14-hydroxyclarithromycin, which has pronounced antimicrobial activity against Haemophilus influenzae. It is an inhibitor of the isoenzymes CYP3A4, CYP3A5 and CYP3A7.

When taken regularly at 250 mg/day, the equilibrium concentrations of the unchanged drug and its main metabolite are 1 and 0.6 μg/ml, respectively; The half-life is 3-4 hours and 5-6 hours, respectively. When the dose is increased to 500 mg/day, the equilibrium concentration of the unchanged drug and its metabolite in plasma is 2.7-2.9 and 0.83-0.88 μg/ml, respectively; half-life is 4.8-5 hours and 6.9-8.7 hours, respectively. At therapeutic concentrations it accumulates in the lungs, skin and soft tissues (concentrations there are 10 times higher than the level in blood serum).

It is excreted by the kidneys and intestines (20-30% in unchanged form, the rest in the form of metabolites). With a single dose of 250 mg and 1200 mg, 37.9 and 46% are excreted by the kidneys, and 40.2 and 29.1% by the intestines, respectively.

Clarithromycinum

From the gastrointestinal tract:
often - diarrhea, vomiting, dyspepsia, nausea, abdominal pain; uncommon - esophagitis, gastroesophageal reflux disease, gastritis, proctalgia, stomatitis, glossitis, bloating, constipation, dry mouth, belching, flatulence, increased concentration of bilirubin in the blood, increased activity of ALT, AST, gamma-glutamyltransferase, alkaline phosphatase, lactate dehydrogenase, cholestasis, hepatitis, including cholestatic and hepatocellular; frequency unknown - acute pancreatitis, discoloration of the tongue and teeth, liver failure, cholestatic jaundice.

Allergic reactions:

often - rash; uncommon - anaphylactoid reaction, hypersensitivity, bullous dermatitis, itching, urticaria, maculopapular rash; frequency unknown - anaphylactic reaction, angioedema, Stevens-Johnson syndrome, toxic epidermal necrolysis, drug rash with eosinophilia and systemic symptoms (DRESS syndrome).

From the side of the central nervous system:

often - headache, insomnia; uncommon - loss of consciousness, dyskinesia, dizziness, drowsiness, tremor, anxiety, increased excitability; frequency unknown - convulsions, psychotic disorders, confusion, depersonalization, depression, disorientation, hallucinations, nightmares, paresthesia, mania.

From the skin:

often - intense sweating; frequency unknown - acne, hemorrhages.

From the senses:

often - violation, perversion of taste; infrequently - vertigo, hearing loss, ringing in the ears.

From the heart and blood vessels:

often - vasodilation; uncommon - cardiac arrest, atrial fibrillation, prolongation of the QT interval on the ECG, extrasystole, atrial flutter.

From the urinary system

: uncommon - increased creatinine concentration, change in urine color.

Metabolism and nutrition:

uncommon - anorexia, decreased appetite, increased urea concentration, change in albumin-globulin ratio.

From the musculoskeletal system:

uncommon - muscle spasm, musculoskeletal stiffness, myalgia; when used while taking statins, it often results in rhabdomyolysis and myopathy.

From the respiratory system:

Uncommon: asthma, nosebleeds, pulmonary embolism.

From the hematopoietic system:

uncommon - leukopenia, neutropenia, eosinophilia, thrombocythemia.

From the blood coagulation system:

infrequently - an increase in the value of the international normalized ratio, prolongation of prothrombin time.

Infectious and parasitic diseases:

infrequently - cellulitis, candidiasis, gastroenteritis, secondary infections (including vaginal).

Local reactions:

very often - phlebitis at the injection site, often - pain at the injection site, inflammation at the injection site.

From the body as a whole:

uncommon - malaise, hyperthermia, asthenia, chest pain, chills, fatigue.

Clarithromycin or Amoxiclav - which is better and stronger for pneumonia

Manufacturer: Lek D.D., Slovenia
Release form: powder for suspension, tablets

Active ingredient: clavulanic acid, amoxicillin

Synonyms: Flemoclav Solutab, Augmentin, Ecoclave

Amoxiclav is a combined imported analogue of Clarithromycin. The drug contains two substances. Amoxicillin kills pathogenic bacteria in the body. Clavulanic acid enhances the effect of the main substance, protecting it from destruction. Amoxiclav is used in pediatrics, ENT practice, gynecology, urology, and dentistry.

The main advantages of the analogue are:

• Possibility of use in pregnant women, premature babies and newborns;
• low rate of adverse reactions;
• average cost;
• variety of forms and dosages.

The medications have similar indications, but for respiratory tract infections, preference is given to the analogue.

Contraindications

Due to the predominance of metabolism in the liver, the use of clarithromycin is contraindicated in patients with severe hepatic impairment.

The use of clarithromycin is contraindicated if there is hypersensitivity to clarithromycin or other macrolide antibiotics (for example, azithromycin).

General use with cisapride, pimozide, terfenadine, or astemizole is prohibited because life-threatening arrhythmias may occur.

In addition, clarithromycin should not be taken with the ergot alkaloids dihydroergotamine and ergotamine. Combined use may lead to intoxication and vasospasm.

Overdose

Do not take more than 2 tablets of Clarithromycin at one time. One of the likely consequences of an antibiotic overdose is fever, abdominal or head pain, nausea, vomiting, and diarrhea. In case of severe manifestations, it is necessary to call a doctor or an ambulance, medical procedures before an overdose: gastric lavage or treatment of other symptoms. For more details, read the instructions.

If an overdose occurs, the patient may experience problems with gastrointestinal function, disturbances of consciousness, and headaches. In this case, gastric lavage is performed and, if necessary, symptomatic treatment is prescribed.

Analogues of Clarithromycin

For the treatment of infectious and inflammatory diseases, analogues and synonyms of Clarithromycin are used. Medicines differ in composition, action, indications, and release form.

List of Clarithromycin analogues with prices

If the question is what can replace Clarithromycin for a bacterial infection, then you should consult a doctor for tests and a prescription.

Indications and spectrum of action

Clarithromycin is used to treat bacterial infections of the respiratory system (such as bronchitis or pneumonia), ear, nose, and throat (such as tonsillitis or sinusitis), and skin (such as impetigo or erysipelas).

Clarithromycin is active against streptococci (including pneumococci), legionella, chlamydia, bacteria without a cell wall (for example mycoplasma), atypical mycobacteria, as well as Bordetella pertussis.

The clinical effectiveness of all macrolides against Haemophilus influenzae is currently considered insufficient.

Clarithromycin is also used in combination therapy to destroy Helicobacter pylori colonies in the gastric mucosa (gastritis).

What properties does the drug have?

Under the influence of the drug on the body, protein compounds in the pathogenic cell are inhibited, subsequently inhibiting the reproduction process.

Clarithromycin is active against streptococci, staphylococci, as well as listeria and corynebacteria. In addition, the drug exhibits increased activity against gram-negative microorganisms:

• Helicobacter pylori;
• gonococcus;
• meningococcus.

In addition, what are Clarithromycin tablets prescribed for? The medicine effectively affects the following pathogens:

• peptococci;
• clostridia;
• legionella;
• chlamydia;
• ureaplasma;
• mycoplasma

In addition, the medication effectively fights toxoplasma and mycobacteria, except for mycobacterium tuberculosis.

Clarithromycin recipe in Latin

The Latin prescription for clarithromycin is prescribed in the form of tablets with a dosage of 250 and 500 mg; in the form of extended-release (ER) tablets 500 mg; in the form of a suspension for oral administration 125 or 250 mg/5 ml; in bottles in powder form 500 mg.

Read the general rules for writing a prescription in Latin here.

For example, let's prescribe clarithromycin at a dosage of 250 mg in tablet form - read more about the recipe for tablets in Latin.

Rp.: Clarithromycini 250 mg Dtd N 14 in tab. S. Orally, 1 tablet 2 times a day.

We will also write out a prescription for clarithromycin in Latin in the form of a suspension with a dosage of 250 mg/5 ml - more details about the recipe for the suspension in Latin. Since the suspensions are produced in bottles, there is no need to indicate them - for more details, see the recipe for the bottles in Latin.

Rp.: Susp. Clarithromycini 250 mg/5 ml Dtd N 10 S. Orally, 1 suspension 2 times a day.

The recipe for clarithromycin in Latin in powder form, more details about the recipe for powder in Latin, will look like this:

Rp.: Pulv. Clarithromycini 0.5 Dtd N 12 S. Dilute with saline. solution, intramuscularly 1 time per day.

Interactions with other drugs

Because clarithromycin inhibits the activity of the cytochrome P450 isoenzyme CYP3A4, the metabolism of many other drugs may be slowed. As a result, their concentration increases and the effect intensifies. There are a huge variety of such drugs, here are the most common examples:

• quinidine and disopyramide,
• anticonvulsant carbamazepine,
• anti-gout remedy - colchicine,
• cardiac glycoside - digoxin,
• statins,
• anticoagulants,
• sildenafil, tadalafil and vardenafil,
• theophylline,
• tolterodine,
• benzodiazepines (triazolbenzodiazepines, e.g. midazolam, triazolam, alprazolam),
• antivirals – zidovudine, atazanavir, saquinavir,
• proton pump blocker omeprazole,
• calcium antagonists,
• itraconazole and others.

Concomitant use of all these drugs with clarithromycin should be carefully monitored.