Clabax 250 mg, 14 pcs.

Clabax has antibacterial, bacteriostatic, bactericidal action.

Indications

Bacterial infections caused by sensitive microorganisms: Infections of the upper respiratory tract (laryngitis, pharyngitis, tonsillitis, sinusitis), lower respiratory tract (bronchitis, incl.including exacerbation of chronic bronchitis, pneumonia, atypical pneumonia), skin and soft tissues (folliculitis, furunculosis, impetigo, wound infection), otitis media; gastric and duodenal ulcer (eradication of Helicobacter pylori in combination therapy), mycobacteriosis (including atypical, in combination with ethambutol and rifabutin), chlamydia.

Active ingredient

Composition

coated tablets 1 tablet clarithromycin 250 mg

How to take, the dosage

Clabax is taken orally. Adults – 250-500 mg 2 times a day for 6-14 days. For children – 7.5 mg/kg/day, maximum – 500 mg/day, for 7-10 days.

Interaction

When concomitant administration increases blood concentrations of drugs metabolized in the liver by cytochrome P450 enzymes – indirect anticoagulants, carbamazepine, theophylline, astemizole, cisapride, terfenadine (2-3 times), triazolam, midazolam, cyclosporine, disopyramide, phenytoin, rifabutin, lovastatin, digoxin, ergot alkaloids and others.
Rare cases of acute skeletal muscle necrosis have been reported to coincide with simultaneous administration of clarithromycin and hydroxymethylglutaryl-CoA reductase inhibitors – lovastatin and simvastatin.
There are reports of increased plasma concentrations of digoxin in patients receiving simultaneously digoxin and clarithromycin tablets. Serum digoxin should be monitored continuously in these patients to avoid digitalis intoxication.
Clarithromycin may decrease clearance of triazolam and thus increase its pharmacological effects with development of drowsiness and confusion.
Concomitant use of clarithromycin and ergotamine (ergot derivatives) may result in acute ergotamine intoxication manifesting as severe peripheral vasospasm.
Concomitant administration of oral zidovudine and clarithromycin tablets to HIV-infected adults may decrease equilibrium zidovudine concentrations. Given that clarithromycin likely alters absorption of oral zidovudine, this interaction is largely avoided when clarithromycin and zidovudine are taken at different hours of the day (at least 4 hours apart).
Concurrent administration of clarithromycin and ritonavir results in increased serum concentrations of clarithromycin. Dose adjustment of clarithromycin in these cases in patients with normal renal function is not required. However, in patients with creatinine Cl between 30 and 60 ml/min the dose of clarithromycin should be reduced by 50% and in patients with creatinine Cl less than 30 ml/min the sustained release clarithromycin tablets should not be prescribed. Such patients are prescribed rapid-release clarithromycin 250 or 500 mg. Clarithromycin in doses greater than 1 g/day should not be administered concomitantly with ritonavir.

Special Instructions

In the presence of chronic liver disease it is necessary to conduct regular monitoring of serum enzymes.
Caution is used against drugs that are metabolized by the liver (it is recommended to measure their concentration in the blood).
In case of coadministration with warfarin or other indirect anticoagulants it is necessary to monitor PV.
Attention should be paid to the possibility of cross-resistance between clarithromycin and other antibiotics from macrolide group, as well as lincomycin and clindamycin.
With long-term or repeated use of the drug, superinfection may develop (reinfection with the same pathogens against the background of the developed disease).

Contraindications

hypersensitivity to antibiotics from the group of macrolides;
coadministration with ergot derivatives;
coadministration with cisapride, pimozide, astemizole and terfenadine. Patients taking these drugs concomitantly with clarithromycin have increased blood concentrations. This may cause prolongation of QT interval and development of cardiac arrhythmias, including ventricular paroxysmal tachycardia, ventricular fibrillation and ventricular flutter or fibrillation;
severe hepatic and/or renal impairment (creatinine Cl less than 30 ml/min);
porphyria.

Side effects

The most common complaints are gastrointestinal complaints (nausea, dyspepsia, abdominal pain, vomiting, and diarrhea). There have been reports of pseudomembranous colitis ranging from moderate to life-threatening. Other adverse reactions include headaches, taste disorders and transient increases in liver enzyme activity.
Rare cases of paresthesias and hepatitis have been reported with elevated blood levels of liver enzymes and the development of cholestasis and jaundice, which in some cases have been severe but usually reversible. In exceptional cases, liver failure with lethal outcome was observed.
Rare cases of increased serum creatinine concentration, development of interstitial nephritis, development of renal failure are known.
Allergic reactions have been observed while taking clarithromycin, the intensity of which varies from urticaria and skin rash to anaphylaxis and Stevens-Johnson syndrome.
There are reports of hearing loss during treatment with clarithromycin, which in most cases recovered after discontinuation of the drug. Taste disorders may occur.
There are reports of glossitis, stomatitis, oral candidiasis, and discoloration of the tongue during clarithromycin treatment. There are also reports of reversible tooth discoloration in most cases in patients treated with clarithromycin.
In rare cases hypoglycemia has been reported; in some of these cases hypoglycemia developed in patients who took oral hypoglycemic agents or insulin during treatment with clarithromycin.
Individual cases of thrombocytopenia and leukopenia have been reported.
Transient adverse effects on the central nervous system have been observed with clarithromycin: dizziness, anxiety, fear, insomnia, nightmares, tinnitus, confusion, disorientation, hallucinations, psychosis, and depersonalization.
Treatment with clarithromycin, as with other macrolides, has rarely resulted in prolongation of the QT interval, ventricular arrhythmias, including ventricular paroxysmal tachycardia and ventricular flutter or fibrillation.

Overdose

Symptoms: gastrointestinal symptoms (nausea, vomiting, diarrhea); headache, confusion.
Treatment: immediate gastric lavage and symptomatic treatment. Hemodialysis and peritoneal dialysis do not significantly alter serum clarithromycin levels.

Similarities