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Brand Names: Claron, Biaxin, Klaricid, Klabax, Claripen, Claridar, Fromilid, Clacid, Infex and others
Generic Name: Clarithromycin
How does it work?
Claron tablets contain the active ingredient clarithromycin, which is a type of medicine known as a macrolide antibiotic. It is used to treat infections caused by bacteria. (NB. Clarithromycin is also available without a brand name, ie as the generic medicine.)
Clarithromycin works by preventing bacteria from producing proteins that are essential to them. Without these proteins the bacteria cannot grow, replicate and increase in numbers. Clarithromycin doesn’t directly kill the bacteria, but leaves them unable to increase in numbers. The remaining bacteria eventually die or are destroyed by the immune system. This treats the infection.
Clarithromycin is a broad-spectrum antibiotic that is active against a wide variety of bacteria that cause a wide variety of infections. Clarithromycin may be used to treat infections of the upper or lower airways, skin or soft tissue, or ears.
To make sure the bacteria causing an infection are susceptible to clarithromycin your doctor may take a tissue sample, for example a swab from the throat or skin.
Claron tablets are known as modified release tablets. They are designed to release the medicine gradually over the day as the tablet passes through the gut. This means they only need to be taken once a day. The tablets should be swallowed whole and not chewed, broken or crushed, as this would stop the modified release design from working.
What is it used for?
* Bacterial infections of the lungs (lower respiratory tract), eg bronchitis, pneumonia
* Bacterial infections of the upper respiratory tract, eg sinusitis, pharyngitis
* Bacterial skin or soft tissue infections eg cellulitis, folliculitis or erysipelas.
* Unless your doctor tells you otherwise, it is important that you finish the prescribed course of this antibiotic medicine, even if you feel better or it seems the infection has cleared up. Stopping the course early increases the chance that the infection will come back and that the bacteria will grow resistant to the antibiotic.
* Broad-spectrum antibiotics can sometimes cause inflammation of the bowel (colitis). For this reason, if you get diarrhoea that becomes severe or persistent or contains blood or mucus, either during or after taking this medicine, you should consult your doctor immediately.
Use with caution in
* Decreased liver function
* Abnormal heart rhythm seen on a heart monitoring trace (ECG) as a 'prolonged QT interval', or people at risk of this (your doctor will know).
Not to be used in
* Children under 12 years of age (other forms of clarithromycin containing a lower dose are suitable for this age group - see links at end of factsheet for more information)
* Decreased kidney function (other forms of clarithromycin containing a lower dose are suitable - see links at end of factsheet for more information)
* Allergy to other macrolide-type antibiotics, eg erythromycin
* People taking pimozide, cisapride, terfenadine or ergot derivatives, eg ergotamine, dihdyroergotamine
* Rare hereditary problems of fructose intolerance, glucose-galactose malabsorption or sucrase-isomaltase insufficiency.
This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.
If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.
Pregnancy and Breastfeeding
Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.
* The safety of this medicine during pregnancy has not been established. It should not be used by pregnant women unless the expected benefit to the mother is greater than any possible risk to the foetus. Seek medical advice from your doctor.
* This medicine passes into breast milk but the effect on the nursing infant is unknown. It should not be used by breastfeeding women unless the expected benefit to the mother is greater than any possible risk to the nursing infant. Seek medical advice from your doctor.
* Take at regular intervals. Complete the prescribed course unless otherwise directed.
* Take this medication with or after food.
* This medication is to be swallowed whole, not chewed.
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.
* Disturbances of the gut such as diarrhoea, nausea, vomiting, indigestion, abdominal pain
* Sore mouth
* Tongue or tooth discolouration
* Oral thrush
* Pain in the muscles or joints
* Disturbance of taste or smell
* Allergic skin reactions
* Difficulty sleeping or bad dreams
* Pins and needles
* Reversible loss of hearing
* Low blood sugar (hypoglycaemia)
* Liver or kidney disorders
* Abnormal heart beats (arrhythmias)
The side effects listed above may not include all of the side effects reported by the drug's manufacturer.
For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.
How can this medicine affect other medicines?
It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to ensure that the combination is safe.
Clarithromycin should not be taken by people who are taking any of the following medicines:
* ergot derivatives, eg ergotamine, dihydroergotamine.
This is because clarithromycin can raise the blood levels of these medicines, resulting in an increased risk of serious side effects on the heart.
Clarithromycin may also increase the blood level of the following medicines:
* rifabutin (increased risk of uveitis)
If the blood levels of these medicines are raised by clarithromycin it may lead to an increase in the effects of these medicines, but also a possible increased risk of their side effects. Combined use should therefore be well monitored.
Clarithromycin may also increase the blood levels and hence anti-blood-clotting effects of the anticoagulants nicoumalone and warfarin. As this may increase the risk of bleeding, people taking these combinations, particularly elderly people, may need more frequent monitoring of their blood clotting time so the dose of anticoagulant can be adjusted if necessary.
Clarithromycin may also increase the blood levels of cholesterol-lowering medicines called statins, eg simvastatin and lovastatin. This may increase the risk of side effects on the muscles (myopathy) from these medicines.
Claron tablets have not been studied in combination with zidovudine. People taking zidovudine who need to take clarithromycin should be prescribed an immediate-release form of the antibiotic, such as those listed at the end of the factsheet.
Ritonavir may increase the blood level of clarithromycin. This is not normally a problem, but if you have kidney problems and are taking ritonavir your doctor may prescribe you a lower than normal dose of clarithromycin.
If you are taking a combined oral contraceptive pill there may be a very low risk that this antibiotic may make it less effective at preventing pregnancy. Although this has not been reported with clarithromycin, the personal and ethical consequences of an unwanted pregnancy can be very serious. For this reason the Family Planning Association recommends that women taking combined oral contraceptives should use an extra method of contraception (eg condoms) while taking a short course of broad-spectrum antibiotic, and for seven days after finishing the course. If the seven days run beyond the end of a pill packet, a new packet should be started without a break (in the case of ED pills the inactive tablets should be omitted).