Drug Characteristics
  • Formulation

    Tablets : 250 mg, 500 mg

    Suspension : 250 mg/5ml

    Injection : 500 mg          

  • Dose

    Atypical mycobacterial infections (MAI) or Mycobacterium Avium Complex (MAC) :

    500 mg orally twice a day (as part of a combination regimen)          

  • Side Effects

    Gastrointestinal disturbances (nausea, dyspepsia, diarrhoea), rash, CNS disturbances (anxiety, headache, dizziness and confusion), taste perversion, hepatic dysfunction

  • Interactions

    Clarithromycin is an inhibitor of cytochrome P450 isoenzymes. May cause raised levels of co-administered drugs also metabolized via this route e.g. warfarin, theophylline, protease inhibitors, rifabutin. Terfenadine and astemizole contraindicated due to risk of cardiac arrhythmias. Azithromycin often used in preference.

  • Renal

    GFR 30–50: Dose as in normal renal function

    GFR 20–30: 

    • Oral: 250–500 mg every 12–24 hours 
    • IV: 250-500 mg every 12 hours

    GFR <10: 

    • Oral: 250 mg every 12–24 hours. 
    • IV: 250 mg every 12 hours
  • Hepatic

    Clarithromycin is both hepatically metabolized and renally excreted

    There are no recommendations on dosing in patients with moderate to severe liver disease and LFTs should be monitored        

  • Pregnancy

    Limited Human Data – Animal Data Suggest High Risk

  • Other Information