Clarithromycin Brand Name– Biaxin | Biaxin XL
What is Clarithromycin
Clarithromycin is an oral macrolide antibiotic similar to erythromycin and azithromycin.
Like azithromycin, clarithromycin penetrates lung tissue and macrophages to a greater degree than does erythromycin.
This may partially explain why clarithromycin is effective against Mycobacterium avium complex (MAC), an indication for which it was approved in December 1993. Although clarithromycin is effective against MAC when used as a single agent, clarithromycin-resistant organisms can appear.
Clarithromycin is commonly used in infections of the respiratory tract, sexually transmitted infections, otitis media, and infections in AIDS patients.
Clarithromycin also has been used to treat gastrointestinal Helicobacter pylori infection and is recommended as part of several triple-drug therapy regimens which include another antimicrobial agent and acid-suppressive therapy.
Clarithromycin was originally approved by the FDA in October 1991. It has subsequently been approved for treatment of H. pylori-associated duodenal ulcer and for the prevention and treatment of MAC in patients with advanced AIDS.
In 1996, clarithromycin was approved for the treatment of community-acquired pneumonia in children. In 2000, an extended-release formulation was approved; it is effective for sinusitis, chronic bronchitis, and was approved for the treatment of mild-to-moderate community-acquired pneumonia in 2001.
Clarithromycin is also being studied for preventing heart disease, however, its efficacy is unclear. The CLARICOR study reported a significant increase in mortality in clarithromycin-treated (500 mg PO qd for 14 days) patients over placebo; the difference was observed after one year or longer of follow-up. Clinical trials of other antibiotics and clarithromycin did not report a statistically significant effect on mortality.
The exact mechanism of this increase in mortality is unknown; as of December 2005, the FDA is not recommending any specific changes to clarithromycin therapy.
Indications
- Bacillus anthracis
- bartonellosis
- Bordetella pertussis
- Borrelia burgdorferi
- bronchitis
- Campylobacter jejuni
- Chlamydophila pneumoniae
- Clostridium perfringens
- community-acquired pneumonia
- Corynebacterium sp.
- Cryptosporidium parvum
- endocarditis prophylaxis
- Gardnerella vaginalis
- Haemophilus influenzae (beta-lactamase negative)
- Haemophilus influenzae (beta-lactamase positive)
- Haemophilus parainfluenzae
- Helicobacter pylori
- Helicobacter pylori (H. pylori) eradication
- Legionella pneumophila
- Listeria monocytogenes
- Moraxella catarrhalis
- Mycobacterium avium
- Mycobacterium avium complex (MAC) prophylaxis
- Mycobacterium avium complex infection
- Mycobacterium chelonae
- Mycobacterium fortuitum
- Mycobacterium intracellulare
- Mycobacterium kansasii
- Mycobacterium leprae
- Mycobacterium marinum
- Mycoplasma pneumoniae
- otitis media
- Pasteurella multocida
- Peptococcus sp.
- Peptostreptococcus sp.
- pertussis (whooping cough)
- pertussis prophylaxis
- pharyngitis
- pneumonia
- Prevotella melaninogenica
- Propionibacterium acnes
- rheumatic fever prophylaxis
- sinusitis
- skin and skin structure infections
- Staphylococcus aureus (MSSA)
- Streptococcus agalactiae (group B streptococci)
- Streptococcus pneumoniae
- Streptococcus pyogenes (group A beta-hemolytic streptococci)
- Streptococcus sp.
- tonsillitis
- Toxoplasma gondii
- Ureaplasma urealyticum
- Viridans streptococci
Side Effects
- abdominal pain
- acne vulgaris
- acute generalized exanthematous pustulosis (AGEP)
- agranulocytosis
- anaphylactoid reactions
- angioedema
- anorexia
- anxiety
- asthenia
- atrial fibrillation
- bleeding
- candidiasis
- cardiac arrest
- chest pain (unspecified)
- chills
- cholestasis
- confusion
- constipation
- depression
- diarrhea
- dizziness
- Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)
- dysgeusia
- dyskinesia
- dyspepsia
- elevated hepatic enzymes
- eosinophilia
- epistaxis
- eructation
- esophagitis
- fatigue
- fever
- flatulence
- gastritis
- gastroesophageal reflux
- glossitis
- hallucinations
- headache
- hearing loss
- hepatic failure
- hepatitis
- hyperbilirubinemia
- hyperhidrosis
- hypoglycemia
- infection
- insomnia
- interstitial nephritis
- jaundice
- leukopenia
- maculopapular rash
- malaise
- mania
- myalgia
- myasthenia
- myopathy
- nausea
- neutropenia
- nightmares
- palpitations
- pancreatitis
- paresthesias
- parosmia
- pruritus
- pseudomembranous colitis
- psychosis
- pulmonary embolism
- purpura
- QT prolongation
- rash
- renal failure (unspecified)
- rhabdomyolysis
- seizures
- Stevens-Johnson syndrome
- stomatitis
- thrombocytopenia
- tinnitus
- tongue discoloration
- tooth discoloration
- torsade de pointes
- toxic epidermal necrolysis
- tremor
- urine discoloration
- urticaria
- ventricular tachycardia
- vertigo
- vomiting
- xerostomia
Monitoring Parameters
- ECG
- LFTs
Contraindications
- apheresis
- AV block
- bradycardia
- breast-feeding
- cardiomyopathy
- celiac disease
- children
- colitis
- colostomy
- diarrhea
- females
- fever
- geriatric
- GI disease
- heart failure
- hepatic disease
- hepatitis
- human immunodeficiency virus (HIV) infection
- hyperparathyroidism
- hypocalcemia
- hypokalemia
- hypomagnesemia
- hypothermia
- hypothyroidism
- ileostomy
- infants
- inflammatory bowel disease
- jaundice
- laboratory test interference
- long QT syndrome
- macrolide hypersensitivity
- mortality
- myasthenia gravis
- myocardial infarction
- neonates
- pheochromocytoma
- pregnancy
- pseudomembranous colitis
- QT prolongation
- renal failure
- renal impairment
- reproductive risk
- rheumatoid arthritis
- sickle cell disease
- sleep deprivation
- stroke
- systemic lupus erythematosus (SLE)
- torsade de pointes
- ulcerative colitis
- ventricular arrhythmias
- viral infection
Interactions
- Abacavir; Lamivudine, 3TC; Zidovudine, ZDV
- Abarelix
- Abemaciclib
- Acalabrutinib
- Acarbose
- Acetaminophen; Butalbital; Caffeine; Codeine
- Acetaminophen; Caffeine; Dihydrocodeine
- Acetaminophen; Codeine
- Acetaminophen; Hydrocodone
- Acetaminophen; Oxycodone
- Acetohexamide
- Ado-Trastuzumab emtansine
- Afatinib
- Albiglutide
- Alfentanil
- Alfuzosin
- Aliskiren; Amlodipine
- Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
- Almotriptan
- Alogliptin
- Alogliptin; Metformin
- Alogliptin; Pioglitazone
- Alosetron
- Alpha-glucosidase Inhibitors
- Alprazolam
- Amiodarone
- Amitriptyline
- Amitriptyline; Chlordiazepoxide
- Amlodipine
- Amlodipine; Atorvastatin
- Amlodipine; Benazepril
- Amlodipine; Celecoxib
- Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
- Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
- Amlodipine; Olmesartan
- Amlodipine; Telmisartan
- Amlodipine; Valsartan
- Amprenavir
- Anagrelide
- Apalutamide
- Apixaban
- Apomorphine
- Aprepitant, Fosaprepitant
- Aripiprazole
- Armodafinil
- Arsenic Trioxide
- Artemether; Lumefantrine
- Asenapine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Aspirin, ASA; Caffeine; Dihydrocodeine
- Aspirin, ASA; Carisoprodol; Codeine
- Aspirin, ASA; Oxycodone
- Aspirin, ASA; Pravastatin
- Atazanavir
- Atazanavir; Cobicistat
- Atomoxetine
- Atorvastatin
- Atorvastatin; Ezetimibe
- Atropine; Hyoscyamine; Phenobarbital; Scopolamine
- Avanafil
- Avapritinib
- Axitinib
- Azelastine; Fluticasone
- Bacillus Calmette-Guerin Vaccine, BCG
- Bedaquiline
- Belladonna Alkaloids; Ergotamine; Phenobarbital
- Benzhydrocodone; Acetaminophen
- Bepridil
- Betamethasone
- Betrixaban
- Bexarotene
- Bicalutamide
- Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
- Bismuth Subsalicylate; Metronidazole; Tetracycline
- Boceprevir
- Bortezomib
- Bosentan
- Bosutinib
- Brexpiprazole
- Brigatinib
- Bromocriptine
- Brompheniramine; Guaifenesin; Hydrocodone
- Brompheniramine; Hydrocodone; Pseudoephedrine
- Budesonide
- Budesonide; Formoterol
- Bupivacaine; Lidocaine
- Buprenorphine
- Buprenorphine; Naloxone
- Buspirone
- Cabazitaxel
- Cabozantinib
- Caffeine; Ergotamine
- Calcifediol
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- Capmatinib
- Carbamazepine
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- Cardiac glycosides
- Cariprazine
- Cenobamate
- Ceritinib
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- Cevimeline
- Chlordiazepoxide
- Chlordiazepoxide; Clidinium
- Chloroquine
- Chlorpheniramine; Codeine
- Chlorpheniramine; Dihydrocodeine; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
- Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Hydrocodone
- Chlorpheniramine; Hydrocodone; Phenylephrine
- Chlorpheniramine; Hydrocodone; Pseudoephedrine
- Chlorpromazine
- Chlorpropamide
- Cilostazol
- Cinacalcet
- Ciprofloxacin
- Cisapride
- Citalopram
- Clindamycin
- Clofazimine
- Clomipramine
- Clonazepam
- Clorazepate
- Clozapine
- Cobicistat
- Cobimetinib
- Codeine
- Codeine; Guaifenesin
- Codeine; Phenylephrine; Promethazine
- Codeine; Promethazine
- Colchicine
- Colchicine; Probenecid
- Conivaptan
- Conjugated Estrogens
- Conjugated Estrogens; Bazedoxifene
- Conjugated Estrogens; Medroxyprogesterone
- Copanlisib
- Crizotinib
- Cyclosporine
- Dabigatran
- Dabrafenib
- Daclatasvir
- Dapagliflozin; Metformin
- Dapagliflozin; Saxagliptin
- Darifenacin
- Darolutamide
- Darunavir
- Darunavir; Cobicistat
- Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Dasatinib
- Deflazacort
- Degarelix
- Delavirdine
- Desflurane
- Desipramine
- Deutetrabenazine
- Dexamethasone
- Dextromethorphan; Promethazine
- Dextromethorphan; Quinidine
- Diazepam
- Dienogest; Estradiol valerate
- Dihydrocodeine; Guaifenesin; Pseudoephedrine
- Dihydroergotamine
- Diltiazem
- Diphenhydramine; Hydrocodone; Phenylephrine
- Disopyramide
- Docetaxel
- Dofetilide
- Dolasetron
- Dolutegravir; Rilpivirine
- Donepezil
- Donepezil; Memantine
- Doravirine
- Doravirine; Lamivudine; Tenofovir disoproxil fumarate
- Doxazosin
- Doxepin
- Doxercalciferol
- Doxorubicin
- Dronabinol
- Dronedarone
- Droperidol
- Drospirenone; Estradiol
- Dulaglutide
- Dutasteride; Tamsulosin
- Duvelisib
- Edoxaban
- Efavirenz
- Efavirenz; Emtricitabine; Tenofovir
- Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
- Elagolix
- Elagolix; Estradiol; Norethindrone acetate
- Elbasvir; Grazoprevir
- Eletriptan
- Elexacaftor; tezacaftor; ivacaftor
- Eliglustat
- Eluxadoline
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Empagliflozin; Linagliptin
- Empagliflozin; Linagliptin; Metformin
- Empagliflozin; Metformin
- Emtricitabine; Rilpivirine; Tenofovir alafenamide
- Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
- Emtricitabine; Tenofovir disoproxil fumarate
- Enalapril; Felodipine
- Encorafenib
- Enflurane
- Enfortumab vedotin
- Entrectinib
- Enzalutamide
- Eplerenone
- Erdafitinib
- Ergonovine
- Ergotamine
- Eribulin
- Erlotinib
- Ertugliflozin; Metformin
- Escitalopram
- Eslicarbazepine
- Estazolam
- Esterified Estrogens
- Esterified Estrogens; Methyltestosterone
- Estradiol
- Estradiol Cypionate; Medroxyprogesterone
- Estradiol; Levonorgestrel
- Estradiol; Norethindrone
- Estradiol; Norgestimate
- Estradiol; Progesterone
- Estropipate
- Eszopiclone
- Ethinyl Estradiol; Etonogestrel
- Etonogestrel
- Etravirine
- Everolimus
- Exenatide
- Ezetimibe; Simvastatin
- Ezogabine
- Fedratinib
- Felbamate
- Felodipine
- Fentanyl
- Fesoterodine
- Fingolimod
- Flecainide
- Flibanserin
- Fluconazole
- Fluoxetine
- Fluoxetine; Olanzapine
- Fluphenazine
- Flurazepam
- Fluticasone
- Fluticasone; Salmeterol
- Fluticasone; Umeclidinium; Vilanterol
- Fluticasone; Vilanterol
- Fluvastatin
- Fluvoxamine
- food
- Formoterol; Mometasone
- Fosamprenavir
- Foscarnet
- Fosphenytoin
- Fostamatinib
- Galantamine
- Gefitinib
- Gemifloxacin
- Gemtuzumab Ozogamicin
- Gilteritinib
- Glasdegib
- Glecaprevir; Pibrentasvir
- Glimepiride
- Glimepiride; Pioglitazone
- Glimepiride; Rosiglitazone
- Glipizide
- Glipizide; Metformin
- Glyburide
- Glyburide; Metformin
- Goserelin
- Granisetron
- grapefruit juice
- Guaifenesin; Hydrocodone
- Guaifenesin; Hydrocodone; Pseudoephedrine
- Guanfacine
- Halofantrine
- Halogenated Anesthetics
- Haloperidol
- Halothane
- Histrelin
- Homatropine; Hydrocodone
- Hydrocodone
- Hydrocodone; Ibuprofen
- Hydrocodone; Phenylephrine
- Hydrocodone; Potassium Guaiacolsulfonate
- Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
- Hydrocodone; Pseudoephedrine
- Hydrocortisone
- Hydroxychloroquine
- Hydroxyprogesterone
- Hydroxyzine
- Ibrutinib
- Ibuprofen; Oxycodone
- Ibutilide
- Idelalisib
- Ifosfamide
- Iloperidone
- Imatinib
- Imipramine
- Incretin Mimetics
- Indinavir
- Inotuzumab Ozogamicin
- Insulin Degludec; Liraglutide
- Insulin Glargine; Lixisenatide
- Insulins
- Irinotecan
- Irinotecan Liposomal
- Isavuconazonium
- Isoflurane
- Isoniazid, INH; Pyrazinamide, PZA; Rifampin
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- Isradipine
- Istradefylline
- Itraconazole
- Ivabradine
- Ivacaftor
- Ivosidenib
- Ixabepilone
- Ketoconazole
- Lamivudine, 3TC; Zidovudine, ZDV
- Lamivudine; Tenofovir Disoproxil Fumarate
- Lapatinib
- Larotrectinib
- Lefamulin
- Lemborexant
- Lenvatinib
- Letermovir
- Leuprolide
- Leuprolide; Norethindrone
- Levobupivacaine
- Levofloxacin
- Levomethadyl
- Levomilnacipran
- Lidocaine
- Lidocaine; Prilocaine
- Linagliptin
- Linagliptin; Metformin
- Liraglutide
- Lithium
- Lixisenatide
- Lofexidine
- Lomefloxacin
- Lomitapide
- Long-acting beta-agonists
- Loperamide
- Loperamide; Simethicone
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- Lorlatinib
- Lovastatin
- Lovastatin; Niacin
- Lumacaftor; Ivacaftor
- Lumacaftor; Ivacaftor
- Lumateperone
- Lurasidone
- Lurbinectedin
- Macimorelin
- Maprotiline
- Maraviroc
- Mefloquine
- Meperidine; Promethazine
- Metformin
- Metformin; Pioglitazone
- Metformin; Repaglinide
- Metformin; Rosiglitazone
- Metformin; Saxagliptin
- Metformin; Sitagliptin
- Methadone
- Methylergonovine
- Methylprednisolone
- Methysergide
- Metronidazole
- Midazolam
- Midostaurin
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- Miglitol
- Mirtazapine
- Mitotane
- Modafinil
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- Moxifloxacin
- Naldemedine
- Naloxegol
- Nanoparticle Albumin-Bound Paclitaxel
- Nateglinide
- Neratinib
- Netupitant, Fosnetupitant; Palonosetron
- Nevirapine
- Niacin; Simvastatin
- Nicardipine
- Nifedipine
- Nilotinib
- Nimodipine
- Nintedanib
- Nisoldipine
- Norfloxacin
- Nortriptyline
- Octreotide
- Ofloxacin
- Olanzapine
- Olaparib
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- Omeprazole; Amoxicillin; Rifabutin
- Ondansetron
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- Oritavancin
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- Ospemifene
- Oxaliplatin
- Oxcarbazepine
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- Oxycodone
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- Palbociclib
- Paliperidone
- Panobinostat
- Paricalcitol
- Pasireotide
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- Pentamidine
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- Perphenazine; Amitriptyline
- Pexidartinib
- Phenobarbital
- Phenylephrine; Promethazine
- Phenytoin
- Pimavanserin
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- Pioglitazone
- Pitolisant
- Polatuzumab Vedotin
- Ponatinib
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- Pramlintide
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- Retapamulin
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- Rimegepant
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- Risperidone
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- Saxagliptin
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- Selumetinib
- Semaglutide
- Sertraline
- Sevoflurane
- SGLT2 Inhibitors
- Short-acting beta-agonists
- Sibutramine
- Sildenafil
- Silodosin
- Simeprevir
- Simvastatin
- Simvastatin; Sitagliptin
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- Sirolimus
- Sitagliptin
- Sodium picosulfate; Magnesium oxide; Anhydrous citric acid
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- Solifenacin
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