Description

Simple

An antibiotic used to treat various bacterial infections in the body, including the skin, ear, and stomach.

Clinical

A macrolide antibiotic used for the treatment of a wide variety of bacterial infections such as acute otitis, pharyngitis, tonsillitis, respiratory tract infections, uncomplicated skin infections, and helicobacter pylori infection.

Overview

Clarithromycin, a semisynthetic macrolide antibiotic derived from erythromycin, inhibits bacterial protein synthesis by binding to the bacterial 50S ribosomal subunit. Binding inhibits peptidyl transferase activity and interferes with amino acid translocation during the translation and protein assembly process. Clarithromycin may be bacteriostatic or bactericidal depending on the organism and drug concentration.

Pharmacology

Indication

An alternative medication for the treatment of acute otitis media caused by H. influenzae, M. catarrhalis, or S. pneumoniae in patients with a history of type I penicillin hypersensitivity. Also for the treatment of pharyngitis and tonsillitis caused by susceptible Streptococcus pyogenes Read more

Pharmacodynamic

Clarithromycin is a macrolide antibiotic whose spectrum of activity includes many gram-positive (Staphylococcus aureus, S. pneumoniae, and S. pyogenes) and gram-negative aerobic bacteria (Haemophilus influenzae, H. parainfluenzae, and Moraxella catarrhalis), many anaerobic bacteria, so... Read more

Mechanism of action

Clarithromycin is first metabolized to 14-OH clarithromycin, which is active and works synergistically with its parent compound. Like other macrolides, it then penetrates bacteria cell wall and reversibly binds to domain V of the 23S ribosomal RNA of the 50S subunit of the bacterial ribosome, blocki... Read more

Absorption

Clarithromycin is well-absorbed, acid stable and may be taken with food.

Protein binding

~ 70% protein bound

Volume of distribution

Information currently not available.

Clearance

Information currently not available.

Half life

3-4 hours

Route of elimination

After a 250 mg tablet every 12 hours, approximately 20% of the dose is excreted in the urine as clarithromycin, while after a 500 mg tablet every 12 hours, the urinary excretion of clarithromycin is somewhat greater, approximately 30%.

Toxicity

Symptoms of toxicity include diarrhea, nausea, abnormal taste, dyspepsia, and abdominal discomfort. Transient hearing loss with high doses has been observed. Pseudomembraneous colitis has been reported with clarithromycin use. Allergic reactions ranging from urticaria and mild skin eruptions to rare... Read more

Adverse Effects

Effect Regions Age Groups Incidences Evidence Type
Taste perversion US
  • Kind: experimental
    • Percent: 15%
  • Kind: comparator
    • Percent: 1%
  • Kind: comparator
    • Percent: 16%
  • Clinical Trial
    Nausea US
    • adult
  • Kind: experimental
    • Percent: 12%
  • Clinical Trial
    Nausea US
  • Kind: experimental
    • Percent: 11%
  • Kind: placebo
    • Percent: 7%
  • Clinical Trial
    Nausea US
  • Kind: experimental
    • Percent: 11%
  • Kind: placebo
    • Percent: 7%
  • Clinical Trial
    Nausea US
  • Kind: experimental
    • Percent: 11%
  • Kind: placebo
    • Percent: 7%
  • Clinical Trial
    Headache US
  • Kind: experimental
    • Percent: 5%
  • Kind: comparator
    • Percent: 6%
  • Kind: comparator
    • Percent: 9%
  • Clinical Trial
    Taste perversion US
  • Kind: experimental
    • Percent: 8%
  • Kind: placebo
    • Percent: 0.3%
  • Clinical Trial
    Taste perversion US
  • Kind: experimental
    • Percent: 8%
  • Kind: placebo
    • Percent: 0.3%
  • Clinical Trial
    Taste perversion US
  • Kind: experimental
    • Percent: 8%
  • Kind: placebo
    • Percent: 0.3%
  • Clinical Trial
    Diarrhea US
  • Kind: experimental
    • Percent: 8%
  • Kind: placebo
    • Percent: 4%
  • Clinical Trial
    Diarrhea US
  • Kind: experimental
    • Percent: 8%
  • Kind: placebo
    • Percent: 4%
  • Clinical Trial
    Diarrhea US
  • Kind: experimental
    • Percent: 8%
  • Kind: placebo
    • Percent: 4%
  • Clinical Trial
    Vomiting US
    • adult
  • Kind: experimental
    • Percent: 8%
  • Clinical Trial
    Diarrhea US
  • Kind: experimental
    • Percent: 4%
  • Kind: comparator
    • Percent: 7%
  • Kind: comparator
    • Percent: 3%
  • Clinical Trial
    Vomiting US
  • Kind: experimental
    • Percent: 6%
  • Kind: placebo
    • Percent: 3%
  • Clinical Trial
    Vomiting US
  • Kind: experimental
    • Percent: 6%
  • Kind: placebo
    • Percent: 3%
  • Clinical Trial
    Vomiting US
  • Kind: experimental
    • Percent: 6%
  • Kind: placebo
    • Percent: 3%
  • Clinical Trial
    Nausea US
  • Kind: experimental
    • Percent: 5%
  • Kind: comparator
    • Percent: 1%
  • Kind: comparator
    • Percent: 3%
  • Clinical Trial
    Abdominal Pain US
  • Kind: experimental
    • Percent: 5%
  • Kind: placebo
    • Percent: 4%
  • Clinical Trial
    Abdominal Pain US
  • Kind: experimental
    • Percent: 5%
  • Kind: placebo
    • Percent: 4%
  • Clinical Trial
    Abdominal Pain US
  • Kind: experimental
    • Percent: 5%
  • Kind: placebo
    • Percent: 4%
  • Clinical Trial
    Low white blood cell count US
  • Kind: experimental
    • Percent: 4%
  • Kind: placebo
    • Percent: 0%
  • Clinical Trial
    Rash US
  • Kind: experimental
    • Percent: 3%
  • Kind: placebo
    • Percent: 4%
  • Clinical Trial
    Rash US
  • Kind: experimental
    • Percent: 3%
  • Kind: placebo
    • Percent: 4%
  • Clinical Trial
    Rash US
  • Kind: experimental
    • Percent: 3%
  • Kind: placebo
    • Percent: 4%
  • Clinical Trial
    Dyspepsia US
  • Kind: experimental
    • Percent: 4%
  • Kind: placebo
    • Percent: 3%
  • Clinical Trial
    Dyspepsia US
  • Kind: experimental
    • Percent: 4%
  • Kind: placebo
    • Percent: 3%
  • Clinical Trial
    Dyspepsia US
  • Kind: experimental
    • Percent: 4%
  • Kind: placebo
    • Percent: 3%
  • Clinical Trial
    Infection US
  • Kind: experimental
    • Percent: 3%
  • Kind: comparator
    • Percent: 2%
  • Kind: comparator
    • Percent: 4%
  • Clinical Trial
    Vomiting US
  • Kind: experimental
    • Percent: 4%
  • Kind: comparator
    • Percent: <1%
  • Kind: comparator
    • Percent: 1%
  • Clinical Trial
    Taste perversion US
    • adult
  • Kind: experimental
    • Percent: 4%
  • Clinical Trial
    Increased alanine transferase US
  • Kind: experimental
    • Percent: 4%
  • Kind: placebo
    • Percent: 2%
  • Clinical Trial
    Headache US
  • Kind: experimental
    • Percent: 3%
  • Kind: placebo
    • Percent: 1%
  • Clinical Trial
    Headache US
  • Kind: experimental
    • Percent: 3%
  • Kind: placebo
    • Percent: 1%
  • Clinical Trial
    Headache US
  • Kind: experimental
    • Percent: 3%
  • Kind: placebo
    • Percent: 1%
  • Clinical Trial
    Abdominal Pain US
  • Kind: experimental
    • Percent: 3%
  • Kind: comparator
    • Percent: 2%
  • Kind: comparator
    • Percent: 1%
  • Clinical Trial
    Increased alanine trans aminase US
    • adult
  • Kind: experimental
    • Percent: 3%
  • Clinical Trial
    Rash US
    • adult
  • Kind: experimental
    • Percent: 3%
  • Clinical Trial
    Diarrhea US
    • adult
  • Kind: experimental
    • Percent: 3%
  • Clinical Trial
    Abdominal Pain US
    • adult
  • Kind: experimental
    • Percent: 3%
  • Clinical Trial
    Increased aspartate transferase US
  • Kind: experimental
    • Percent: 3%
  • Kind: placebo
    • Percent: 2%
  • Clinical Trial
    Flatulence US
  • Kind: experimental
    • Percent: 2%
  • Kind: placebo
    • Percent: 1%
  • Clinical Trial
    Flatulence US
  • Kind: experimental
    • Percent: 2%
  • Kind: placebo
    • Percent: 1%
  • Clinical Trial
    Flatulence US
  • Kind: experimental
    • Percent: 2%
  • Kind: placebo
    • Percent: 1%
  • Clinical Trial
    Increased aspartate transaminase US
    • adult
  • Kind: experimental
    • Percent: 2%
  • Clinical Trial
    Headache US
    • adult
  • Kind: experimental
    • Percent: 2%
  • Clinical Trial
    Elevated gamma glutamyl transferase US
  • Kind: experimental
    • Percent: <1%
  • Clinical Trial
    Evelated alanine transferase US
  • Kind: experimental
    • Percent: <1%
  • Clinical Trial
    Elevated aspartate transferase US
  • Kind: experimental
    • Percent: <1%
  • Clinical Trial
    Elevated bilirubin US
  • Kind: experimental
    • Percent: <1%
  • Clinical Trial

    Contraindications

    • Regions: US
    • Patient Conditions:
        • Name: Chlestatic jaundice
        • Drugbank Id: DBCOND0108272
    • With Drugs:
        • Name: Clarithromycin
        • Drugbank Id: DB01211
    • Regions: US
    • Patient Conditions:
        • Name: Hepatic dysfuntion
        • Drugbank Id: DBCOND0108260
    • With Drugs:
        • Name: Clarithromycin
        • Drugbank Id: DB01211
    • Regions: US
    • With Drugs Coadmin:
        • Name: Ergotamine
        • Drugbank Id: DB00696
    • Regions: US
    • With Drugs Coadmin:
        • Name: Dihydroergotamine
        • Drugbank Id: DB00320
    • Regions: US
    • With Drugs Coadmin:
        • Name: Colchicine
        • Drugbank Id: DB01394
    • Regions: US
    • With Categories Coadmin:
        • Name: Hydroxymethylglutaryl-CoA Reductase Inhibitors
        • Drugbank Id: DBCAT000391
        • Mesh Id: D019161
    • Regions: US
    • With Drugs Coadmin:
        • Name: Cisapride
        • Drugbank Id: DB00604
    • Regions: US
    • With Drugs Coadmin:
        • Name: Pimozide
        • Drugbank Id: DB01100

    Food Interactions

    Take with food. Food increases absorption.