CLARITHROMYCIN

(kla RITH roe MYE sin) Brand: Biaxin, Biaxin XL, Biaxin XL-Pak

What is the most significant information I must know about clarithromycin?

• You must not use this medicine if you are allergic to clarithromycin, or to similar medicines such as azithromycin (Zithromax), erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin, Pediazole), or telithromycin (Ketek).

• You must not use this medicine if you have a life-threatening heart rhythm mess, a history of Long QT syndrome, if you have ever had jaundice or liver problems caused by taking clarithromycin, or if you have liver or kidney malady and are also taking colchicine (Colcrys).

• Do not use clarithromycin if you are also using any of the drugs listed adown. They can interact with clarithromycin and reason serious or life-threatening side effects:

· cisapride (Propulsid);

· pimozide (Orap);

· lovastatin (Mevacor, Altoprev, Advicor) or simvastatin (Zocor, Simcor, Vytorin); or

· ergot medication such as ergotamine (Ergomar, Ergostat, Cafergot, Ercaf, Wigraine), or dihydroergotamine (D.H.E. 45, Migranal Nasal Spray).

• Take this medication for the full predesigned length of time. Your symptoms may improve till the infection is completely cleared. Skipping doses may also magnify your risk of further infection that is resistant to antibiotics. Clarithromycin will not treat a viral infection such as the general cool or flu.

What is clarithromycin?

• Clarithromycin is a macrolide antibiotic. Clarithromycin fights bacteria in your body.

• Clarithromycin is used to treat much various types of bacterial infections affecting the skin and respiratory system. Clarithromycin is also used together with another medicines to treat stomach ulcers caused by Helicobacter pylori.

• Clarithromycin may also be used for purposes not listed in this medicine guide.

What must I discuss with my healthcare provider till taking clarithromycin?

• You must not use this medicine if you are allergic to clarithromycin or to similar medicines such as azithromycin (Zithromax), erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin, Pediazole), or telithromycin (Ketek).

• Do not use clarithromycin if you are also using any of the drugs listed adown. They can interact with clarithromycin and reason serious or life-threatening side effects:

· cisapride (Propulsid);

· pimozide (Orap);

· lovastatin (Mevacor, Altoprev, Advicor) or simvastatin (Zocor, Simcor, Vytorin); or

· ergot medication such as ergotamine (Ergomar, Ergostat, Cafergot, Ercaf, Wigraine), or dihydroergotamine (D.H.E. 45, Migranal Nasal Spray).

• To create certain you can safely take clarithromycin, speak your doctor if you have any of these another conditions:

· liver disease;

· kidney disease;

· myasthenia gravis;

· porphyria;

· an electrolyte imbalance (such as low levels of potassium or magnesium in your blood);

· a family history of Long QT syndrome; or

· if you take any of these heart rhythm medications -- amiodarone (Cordarone, Pacerone), disopyramide (Norpace), dofetilide (Tikosyn), flecainide (Tambocor), dronedarone (Multaq), ibutilide (Corvert), mexiletine (Mexitil), procainamide (Procan, Pronestyl), propafenone, (Rythmol), quinidine (Quin-G), or sotalol (Betapace).

• FDA pregnancy category C. It is not known whether clarithromycin will harm an unborn child. Before you take clarithromycin, speak your doctor if you are pregnant or plan to become pregnant while using this medication.

• It is not known whether clarithromycin passes into breast milk or if it could harm a nursing child. Do not use this medicine without telling your doctor if you are breast-feeding a baby.

• Do not give this medication to a baby younger than 6 months of age.

• Older adults may be more likely to have side effects on heart rhythm, including a life-threatening quick heart rate.

How must I take clarithromycin?

• Take exactly as predesigned by your doctor. Do not take in larger or less amounts or for longer than recommended. Follow the directions on your prescription label.

• You may take clarithromycin tablets and oral suspension (liquid) with or without food.

• Clarithromycin extended-release tablets (Biaxin XL) must be taken with food.

• Do not crush, chew, or interrupt an extended-release tablet. Swallow it intact. Breaking the pill may reason too many of the drug to be released at one time.

• Shake the oral suspension (liquid) well just till you measure a doze. Measure the liquid with a particular dose-measuring spoon or medication cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

• Store at room temperature away from moisture and heat. Do not hold the oral liquid in a refrigerator.

What happens if I miss a dose?

• Take the missed doze as soon as you remember. Skip the missed doze if it is nearly time for your following scheduled doze. Do not take extra medication to create up the missed dose.

What happens if I overdose?

• Search abnormal medical attention or call the Poison Help line at 1-800-222-1222.

• Overdose symptoms may include severe stomach pain, nausea, vomiting, or diarrhea.

What must I avoid while taking clarithromycin?

• Antibiotic medicines can reason diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or bloody, stop taking clarithromycin and call your doctor. Do not use anti-diarrhea medication unless your doctor tells you to.

What are the possible side effects of clarithromycin?

• Get abnormal medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your person, lips, tongue, or throat.

• Call your doctor at once if you have a serious side effect such as:

· headache with chest pain and severe dizziness, quick or pounding heartbeats, shortness of breath, fainting;

· diarrhea that is watery or bloody;

· fever, swollen glands, body aches, flu symptoms, new or worsening cough;

· skin rash, light bruising or bleeding, severe tingling, numbness, pain, muscle weakness;

· confusion, vomiting, swelling, rapid weight gain, urinating smaller than normal or not at all;

· problems with your hearing; or

· severe skin reaction -- fever, sore throat, swelling in your person or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the person or upper body) and causes blistering and peeling.

• Clarithromycin may also reason severe liver symptoms. Stop taking clarithromycin and call your doctor at once if you have any of these liver symptoms:

· low fever, itching;

· nausea, upper stomach pain, loss of appetite;

· dark urine, clay colored stools; or

· jaundice (yellowing of the skin or eyes).

• Smaller serious side effects may include:

· upset stomach, vomiting, diarrhea;

· unusual or unpleasant taste in your mouth;

· tooth discoloration;

· headache;

· mild itching or rash; or

· vaginal itching or discharge.

• This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may message side effects to FDA at 1-800-FDA-1088.

What another drugs will affect clarithromycin?

• Speak your doctor about all another medicines you use, especially:

· a blood thinner such as warfarin (Coumadin, Jantoven);

· colchicine (Colcrys);

· itraconazole (Sporanox);

· omeprazole (Prilosec);

· ranitidine bismuth citrate (Tritec);

· sildenafil (Viagra), tadalafil (Adcirca, Cialis), or vardenafil (Levitra);

· theophylline (Elixophyllin, Theo-24, Theochron, Uniphyl);

· tolterodine (Detrol);

· any another antibiotic, especially rifabutin (Mycobutin), rifapentine (Priftin), or rifampin (Rifater, Rifadin, Rifamate);

· cholesterol-lowering medicines such as atorvastatin (Lipitor, Caduet), pravastatin (Pravachol), and others;

· drugs that weaken your immune system, such as cyclosporine (Neoral, Sandimmune, Gengraf), tacrolimus (Prograf), or steroids;

· heart medicine such as amlodipine (Norvasc, Caduet, Exforge, Lotrel, Tekamlo, Tribenzor, Twynsta, Amturnide), digoxin (digitalis, Lanoxicaps, Lanoxin), diltiazem (Cartia, Cardizem), verapamil (Calan, Covera, Isoptin, Verelan), and others;

· HIV medicines such as atazanavir (Reyataz), efavirenz (Sustiva, Atripla), nevirapine (Viramune), ritonavir (Norvir, Kaletra), saquinavir (Invirase), or zidovudine (Retrovir);

· insulin or oral diabetes medication;

· a sedative such as alprazolam (Xanax), midazolam (Versed), or triazolam (Halcion); or

· seizure medications such as carbamazepine (Carbatrol, Equetro, Tegretol), phenytoin (Dilantin), and valproic acid (Depakote, Depakene).

• This list is not complete and there are much another drugs that can interact with clarithromycin. Speak your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal commodity. Do not start a new medicine without telling your doctor. Hold a list of all your medicines and show it to any healthcare provider who treats you.

Where can I get more information?

• Your pharmacist can provide more information about clarithromycin.

Remember, hold this and all another medicines out of the reach of children, never share your medicines with others, and use this medicine only for the indication prescribed.

Disclaim: Each effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses external of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way must be construed to indicate that the drug or drug combination is safety, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the help of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

(43)