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Clarithromycin ER
Clarithromycin ER (extended-release) is a macrolide antibiotic used to treat a wide range of bacterial infections, including respiratory tract infections, skin infections, and Helicobacter pylori infections that cause stomach ulcers. It works by inhibiting bacterial protein synthesis, which stops bacterial growth and replication. Clarithromycin ER is commonly prescribed to treat infections that are not responding to other antibiotics and is particularly useful for treating community-acquired pneumonia and sinusitis. This extended-release formulation allows for once-daily dosing, making it easier for patients to adhere to treatment.
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Frequently Asked Questions
How long does it take for Clarithromycin ER to work?
You may start to feel better within a few days of starting treatment, but it is important to complete the full course of the medication to ensure the infection is fully treated.
Can I take Clarithromycin ER with food?
Yes, it is recommended to take Clarithromycin ER with food to improve absorption and reduce the risk of stomach upset.
What should I do if I miss a dose of Clarithromycin ER?
Take the missed dose as soon as you remember, unless it is almost time for the next dose. Do not double up on doses to make up for the missed one.
Can I drink alcohol while taking Clarithromycin ER?
It is generally safe to drink alcohol in moderation while taking Clarithromycin ER, but alcohol may increase the risk of side effects such as stomach upset. It is best to consult your healthcare provider.
Is Clarithromycin ER safe for long-term use?
Clarithromycin ER is typically prescribed for short-term use to treat bacterial infections. Long-term use is not recommended due to the risk of bacterial resistance and potential side effects. Consult your doctor if long-term treatment is necessary.
Comprehensive Drug Guide
How Does Clarithromycin ER Work?
Clarithromycin ER works by binding to the 50S ribosomal subunit of susceptible bacteria, inhibiting bacterial protein synthesis. This action prevents the bacteria from growing and multiplying, allowing the body's immune system to eliminate the infection. The extended-release formulation allows for a slow and steady release of the medication over time, providing continuous bacterial suppression.
What is Clarithromycin ER Used For?
Common Dosages
Clarithromycin ER is available in the following form:
- Extended-release tablets: 500 mg
Typical Dosing
- For respiratory tract infections: 1,000 mg (two 500 mg tablets) once daily for 5 to 14 days, depending on the infection.
- For skin infections: 1,000 mg once daily for 7 to 14 days.
- For Helicobacter pylori infections: 500 mg twice daily, typically as part of a triple therapy regimen with amoxicillin and a proton pump inhibitor for 10 to 14 days.
Typical Dosing
FDA Approved Indications
- Community-acquired pneumonia
- Acute bacterial exacerbation of chronic bronchitis
- Acute maxillary sinusitis
- Pharyngitis or tonsillitis caused by Streptococcus pyogenes
- Skin and skin structure infections
- Helicobacter pylori infections (as part of combination therapy to treat duodenal ulcers)
Who Shouldn't Take Clarithromycin ER?
- Known allergy to clarithromycin, erythromycin, or other macrolide antibiotics
- History of QT prolongation or ventricular arrhythmias
- Concurrent use of medications metabolized by CYP3A4, such as ergotamine or pimozide
- Severe liver disease or jaundice associated with prior use of clarithromycin
Advice From The Pharmacist
- Take Clarithromycin ER with food to improve absorption and reduce stomach upset.
- Swallow the tablet whole; do not crush or chew it, as this can affect the extended-release mechanism.
- Finish the full course of antibiotics, even if symptoms improve early, to prevent bacterial resistance.
- Avoid taking Clarithromycin ER with grapefruit or grapefruit juice, as this can increase the risk of side effects.
- Inform your doctor if you are taking other medications, especially statins or anticoagulants, as Clarithromycin ER can interact with many drugs.
Side Effects of Clarithromycin ER
Common Side Effects
- Nausea
- Diarrhea
- Headache
- Abdominal pain
- Altered taste
Uncommon/Severe Side Effects
- Severe allergic reactions (rash, swelling, difficulty breathing)
- Liver problems (yellowing of the skin or eyes, dark urine)
- Irregular heartbeat (QT prolongation)
- Clostridioides difficile-associated diarrhea
Risks and Warnings of Clarithromycin ER
- QT Prolongation: Clarithromycin ER can prolong the QT interval, increasing the risk of arrhythmias. Patients with a history of heart rhythm disorders should inform their doctor before taking this medication.
- Liver Toxicity: Clarithromycin ER may cause liver dysfunction in some patients. If you experience symptoms such as jaundice, dark urine, or abdominal pain, contact your healthcare provider immediately.
- Drug Interactions: Clarithromycin ER interacts with many medications, especially those metabolized by the liver enzyme CYP3A4, such as statins and anticoagulants. Ensure that your healthcare provider is aware of all the medications you are taking.
Interactions with Clarithromycin ER
Common Drug Interactions
- Statins: Clarithromycin ER can increase the levels of statins in the body, increasing the risk of muscle toxicity (rhabdomyolysis). Dosage adjustments may be necessary.
- Warfarin: This medication can enhance the effects of warfarin, leading to an increased risk of bleeding. Regular monitoring of INR levels is recommended.
- Theophylline: Clarithromycin may increase the levels of theophylline, potentially leading to toxicity. Close monitoring of theophylline levels is required.
Alternatives to Clarithromycin ER
- Azithromycin: Another macrolide antibiotic commonly used for respiratory and skin infections, with a shorter duration of treatment.
- Amoxicillin-Clavulanate: A combination antibiotic that is commonly used for respiratory tract infections and skin infections.
- Levofloxacin: A fluoroquinolone antibiotic often used for respiratory infections when macrolides are contraindicated.
