Klacid in diseases of the thyroid gland. Klacid is a macrolide antibiotic. International non-proprietary name

Brief information on the drug

INN:

clarithromycin.

Registration number:

P N012722/2, LS-000679.
Film-coated tablets 250 mg.
Film-coated tablets 500 mg.

Indications for use:

infectious and inflammatory diseases caused by microorganisms sensitive to clarithromycin: infections of the lower respiratory tract (such as bronchitis, pneumonia); infections of the upper respiratory tract and ENT organs (such as pharyngitis, sinusitis); infections of the skin and soft tissues (such as folliculitis, inflammation of the subcutaneous tissue, erysipelas); disseminated or localized mycobacterial infections caused by Mycobacterium avium and Mycobacterium intracellulare; localized infections caused by Mycobacterium chelonae, Mycobacterium fortuitum and Mycobacterium kansasii; prevention of the spread of infection caused by the Mycobacterium avium complex (MAC) in HIV-infected patients with a content of CD4 lymphocytes (T-helper lymphocytes) not more than 100 per 1 mm 3; eradication H. pylori and reducing the frequency of recurrence of duodenal ulcers; odontogenic infections (for a dosage of 250 mg).

Contraindications:

hypersensitivity to the components of the drug and other macrolides; concomitant use of clarithromycin with the following drugs: astemizole, cisapride, pimozide, terfenadine; concomitant use of clarithromycin with ergot alkaloids, for example, ergotamine, dihydroergotamine; concomitant use of clarithromycin with oral midazolam; patients with a history of QT interval prolongation, ventricular arrhythmia or torsades de pointes; patients with hypokalemia (risk of prolongation of the QT interval); patients with severe liver failure occurring simultaneously with renal failure; concomitant use of clarithromycin with HMG-CoA reductase inhibitors (statins), which are largely metabolized by the CYP3A4 isoenzyme (lovastatin, simvastatin), due to an increased risk of myopathy, including rhabdomyolysis; concomitant use of clarithromycin with colchicine in patients with impaired liver or kidney function; patients with a history of cholestatic jaundice/hepatitis that developed while using clarithromycin; porphyria; breastfeeding period; children under 12 years of age (efficacy and safety have not been established).

Carefully:

moderate to severe renal failure; hepatic insufficiency of moderate and severe degree; myasthenia gravis (possibly increased symptoms); concomitant use of clarithromycin with benzodiazepines such as alprazolam, triazolam, intravenous midazolam; simultaneous administration with drugs that are metabolized by the CYP3A isoenzyme, for example, carbamazepine, cilostazol, cyclosporine, disopyramide, methylprednisolone, omeprazole, indirect anticoagulants (for example, warfarin), quinidine, rifabutin, sildenafil, tacrolimus, vinblastine; simultaneous administration with drugs that induce the CYP3A4 isoenzyme, for example, rifampicin, phenytoin, carbamazepine, phenobarbital, St. John's wort; simultaneous reception with calcium channel blockers that are metabolized by the CYP3A4 isoenzyme (for example, verapamil, amlodipine, diltiazem); patients with coronary heart disease (CHD), severe heart failure, hypomagnesemia, severe bradycardia (less than 50 beats / min), as well as patients simultaneously taking class IA antiarrhythmic drugs (quinidine, procainamide) and class III (dofetilide, amiodarone, sotalol) ; pregnancy.

Use during pregnancy and during breastfeeding:

the use of clarithromycin during pregnancy (especially in the first trimester) is possible only in the absence of alternative therapy, and the potential benefit to the mother outweighs the potential risk to the fetus. Clarithromycin is excreted in breast milk. If necessary, admission during lactation, breastfeeding should be discontinued.

Dosage and administration:

for oral administration, regardless of food intake. The usual recommended dose of clarithromycin in adults and children over 12 years of age is 250 mg twice daily. In more severe cases, the dose is increased to 500 mg 2 times a day. The usual duration of treatment is from 5 to 14 days (with the exception of community-acquired pneumonia and sinusitis - from 6 to 14 days). Doses for the treatment of mycobacterial infections other than tuberculosis- 500 mg of clarithromycin 2 times a day. Treatment of disseminated MAC infections in patients with AIDS should be continued as long as there is clinical and microbiological efficacy. Clarithromycin should be administered in combination with other antimicrobials active against these pathogens. The duration of treatment for other non-tuberculous mycobacterial infections is determined by the doctor. For the prevention of infections caused by MAC: the recommended dose of clarithromycin for adults is 500 mg 2 times a day. For odontogenic infections The dose of clarithromycin is 250 mg (1 tablet) twice a day for 5 days ( use 250mg tablets). For H. Pylori eradication: combination treatment with three drugs: clarithromycin, 500 mg 2 times a day, in combination with lansoprazole, 30 mg 2 times a day, and amoxicillin, 1000 mg 2 times a day, for 10 days. Clarithromycin 500 mg twice daily in combination with omeprazole 20 mg twice daily and amoxicillin 1000 mg twice daily for 7-10 days. Patients with renal insufficiency with a creatinine clearance of less than 30 ml / min, half the usual dose of clarithromycin is prescribed, i.e. 250 mg (1 tablet) once daily or, for more severe infections, 1 tablet (250 mg) twice daily. Treatment of such patients continue no more than 14 days.

Side effect:

rash; headache, insomnia; intense sweating; diarrhea, vomiting, dyspepsia, nausea, abdominal pain; dysgeusia, taste perversion; vasodilation; deviation in the liver test. A list of all side effects is provided in the instructions for use..

Overdose:

in case of overdose, the unabsorbed drug should be removed from the gastrointestinal tract and symptomatic therapy should be carried out. Hemodialysis and peritoneal dialysis do not have a significant effect on the concentration of clarithromycin in serum, which is typical for other drugs of the macrolide group.

Interaction with other drugs:

drugs that are CYP3A inducers (eg, rifampicin, phenytoin, carbamazepine, phenobarbital, St. John's wort) may induce the metabolism of clarithromycin. The following drugs have a proven or suspected effect on the concentration of clarithromycin in plasma; when co-administered with clarithromycin, dose adjustments or switching to alternative treatments may be required: efavirenz, nevirapine, rifampicin, rifabutin, rifapentine, etravirine, fluconazole, ritonavir, oral hypoglycemic agents/insulin (careful monitoring of glucose levels is recommended). Antiarrhythmic drugs (quinidine and disopyramide): Pirouette-type ventricular tachycardia may occur with the combined use of clarithromycin and quinidine or disopyramide. CYP3A-mediated interactions: Co-administration of clarithromycin, which is known to inhibit CYP3A, and drugs primarily metabolized by CYP3A may be associated with a mutual increase in their concentrations, which may enhance or prolong both therapeutic and side effects. HMG-CoA reductase inhibitors (statins): if co-administration is necessary, it is recommended to take the lowest dose of a statin, it is necessary to use statins that are not dependent on CYP3A metabolism. Indirect anticoagulants: when warfarin and clarithromycin are taken together, bleeding is possible, a pronounced increase in INR and prothrombin time. Full information on drug interactions is provided in the instructions for use..

Special instructions:

prolonged use of antibiotics can lead to the formation of colonies with an increased number of non-susceptible bacteria and fungi. With superinfection, appropriate therapy should be prescribed. When using clarithromycin, cases of hepatic dysfunction (increased concentrations of liver enzymes in the blood, hepatocellular and / or cholestatic hepatitis with or without jaundice) have been reported. Hepatic dysfunction can be severe but is usually reversible. There are cases of fatal liver failure, mainly associated with the presence of serious concomitant diseases and / or the simultaneous use of other drugs. If signs and symptoms of hepatitis occur, such as anorexia, jaundice, dark urine, itching, abdominal tenderness on palpation, clarithromycin therapy should be discontinued immediately. In the presence of chronic liver diseases, it is necessary to conduct regular monitoring of blood serum enzymes. In the treatment of almost all antibacterial agents, including clarithromycin, cases of pseudomembranous colitis have been described, the severity of which can vary from mild to life-threatening. Antibacterial drugs can change the normal intestinal microflora, which can lead to growth C.difficile. Pseudomembranous colitis due to Clostridium difficile should be suspected in all patients who experience diarrhea after antibiotic use. After a course of antibiotic therapy, careful medical monitoring of the patient is necessary. Cases of the development of pseudomembranous colitis 2 months after taking antibiotics were described. Clarithromycin should be used with caution in patients with ischemic heart disease (CHD), severe heart failure, hypomagnesaemia, severe bradycardia (less than 50 beats / min), as well as when used simultaneously with class IA antiarrhythmic drugs (quinidine, procainamide) and class III ( dofetilide, amiodarone, sotalol). Under these conditions and while taking the drug with these drugs, you should regularly monitor the electrocardiogram for an increase in the QT interval. It is possible to develop cross-resistance to clarithromycin and other antibiotics of the macrolide group, as well as lincomycin and clindamycin. Given the growing resistance Streptococcus pneumoniae to macrolides, it is important to perform susceptibility testing when prescribing clarithromycin to patients with community-acquired pneumonia. In nosocomial pneumonia, clarithromycin should be used in combination with appropriate antibiotics. Mild to moderate skin and soft tissue infections are most often caused by Staphylococcus aureus and Streptococcus pyogenes. In this case, both pathogens can be resistant to macrolides. Therefore, it is important to conduct a sensitivity test. Macrolides can be used for infections caused by Corynebacterium minutissimum(erythrasma), diseases acne vulgaris and erysipelas, as well as in situations where penicillin cannot be used. In the event of acute hypersensitivity reactions such as anaphylactic reaction, Stevens-Johnson syndrome, toxic epidermal necrolysis, drug rash with eosinophilia and systemic symptoms (DRESS syndrome), Henoch-Schonlein purpura, clarithromycin should be immediately discontinued and appropriate therapy initiated. Exacerbation of symptoms of myasthenia gravis has been reported in patients taking clarithromycin. In the case of joint use with warfarin or other indirect anticoagulants, it is necessary to control INR and prothrombin time.

Influence on the ability to drive vehicles and engage in other potentially hazardous activities that require increased concentration of attention and speed of psychomotor reactions:

there are no data on the effect of clarithromycin on the ability to drive and use machines. The potential for dizziness, vertigo, confusion and disorientation that may occur while taking this drug should be taken into account. Care should be taken when driving vehicles and engaging in other potentially hazardous activities that require an increased concentration of attention and speed of psychomotor reactions.

Brief information on the drug

INN:

clarithromycin.

Registration number:

ПN012722/01, ЛС-000681.

Powder for suspension for oral administration 125 mg/5 ml.
Powder for suspension for oral administration 250 mg/5 ml.

Indications for use:

infectious and inflammatory diseases caused by microorganisms sensitive to clarithromycin: infections of the lower respiratory tract (such as bronchitis, pneumonia); upper respiratory tract infections (such as pharyngitis, sinusitis); infections of the skin and soft tissues (such as folliculitis, inflammation of the subcutaneous tissue, erysipelas); disseminated or localized mycobacterial infections caused by Mycobacterium avium and Mycobacterium intracellulare; localized infections caused by Mycobacterium chelonae, Mycobacterium fortuitum and Mycobacterium kansasii; acute otitis media.

Contraindications:

hypersensitivity to the components of the drug and other macrolides; concomitant use of clarithromycin with the following drugs: astemizole, cisapride, pimozide, terfenadine; concomitant use of clarithromycin with ergot alkaloids, for example, ergotamine, dihydroergotamine; concomitant use of clarithromycin with oral midazolam; patients with a history of QT interval prolongation, ventricular arrhythmia or torsades de pointes; patients with hypokalemia (risk of prolongation of the QT interval); patients with severe liver failure occurring simultaneously with renal failure; concomitant use of clarithromycin with HMG-CoA reductase inhibitors (statins), which are largely metabolized by the CYP3A4 isoenzyme (lovastatin, simvastatin), due to an increased risk of myopathy, including rhabdomyolysis; concomitant use of clarithromycin with colchicine in patients with impaired liver or kidney function; patients with a history of cholestatic jaundice/hepatitis that developed while using clarithromycin; porphyria; breastfeeding period; patients with congenital fructose intolerance, sucrase-isomaltase deficiency, glucose-galactose malabsorption syndrome.

Carefully: moderate to severe renal failure; hepatic insufficiency of moderate and severe degree; myasthenia gravis (possibly increased symptoms); concomitant use of clarithromycin with benzodiazepines such as alprazolam, triazolam, intravenous midazolam; simultaneous administration with drugs that are metabolized by the CYP3A isoenzyme, for example, carbamazepine, cilostazol, cyclosporine, disopyramide, methylprednisolone, omeprazole, indirect anticoagulants (for example, warfarin), quinidine, rifabutin, sildenafil, tacrolimus, vinblastine; simultaneous administration with drugs that induce the CYP3A4 isoenzyme, for example, rifampicin, phenytoin, carbamazepine, phenobarbital, St. John's wort; simultaneous reception with calcium channel blockers that are metabolized by the CYP3A4 isoenzyme (for example, verapamil, amlodipine, diltiazem); patients with coronary heart disease (CHD), severe heart failure, hypomagnesemia, severe bradycardia (less than 50 beats / min), as well as patients simultaneously taking class IA antiarrhythmic drugs (quinidine, procainamide) and class III (dofetilide, amiodarone, sotalol) ; pregnancy; diabetes mellitus (the preparation contains sucrose).

Use during pregnancy and during breastfeeding:

Dosage and administration:

for oral administration. The finished suspension can be taken with or without food, including with milk. Preparation for use: gradually add water to the mark in the vial and shake to obtain 60 ml (125 mg/5 ml) or 100 ml (250 mg/5 ml) suspension. The recommended daily dose of clarithromycin suspension for non-mycobacterial infections in children is 7.5 mg/kg twice daily (maximum 500 mg twice daily). The usual duration of treatment is 5-10 days, depending on the pathogen and the severity of the condition. In children with disseminated or localized mycobacterial infections (M. avium, M. intracellulare, M. chelonae, M. fortuitum, M. kansasii), the recommended daily dose of clarithromycin is 7.5-15 mg/kg 2 times a day. In children with creatinine clearance less than 30 ml/min, the dose of clarithromycin should be halved.

Side effect:

allergic reactions: rash; from the nervous system: headache, insomnia; on the part of the skin: intense sweating; from the digestive system: diarrhea, vomiting, dyspepsia, nausea, pain in the abdomen; on the part of the senses: dysgeusia, taste perversion; from the side of the cardiovascular system: vasodilation; laboratory indicators: deviation in the liver test. A list of all side effects is presented in the instructions for use.

Overdose:

in case of overdose, the unabsorbed drug should be removed from the gastrointestinal tract and symptomatic therapy should be carried out. Hemodialysis and peritoneal dialysis do not significantly affect the concentration of clarithromycin in serum, which is also characteristic of other drugs of the macrolide group.

Interaction with other drugs:

drugs that are CYP3A inducers (eg, rifampicin, phenytoin, carbamazepine, phenobarbital, St. John's wort) may induce the metabolism of clarithromycin. The following drugs have a proven or suspected effect on the concentration of clarithromycin; if co-administered with clarithromycin, dose adjustment or switching to alternative treatment may be required: efavirenz, nevirapine, rifampicin, rifabutin, rifapentine, etravirine, fluconazole, ritonavir, oral hypoglycemic agents / insulin (careful monitoring of glucose levels is recommended). Antiarrhythmic drugs (quinidine and disopyramide): Pirouette-type ventricular tachycardia may occur with the co-administration of clarithromycin and quinidine or disopyramide. CYP3A-mediated interactions: Co-administration of clarithromycin, which is known to inhibit the CYP3A isoenzyme, and drugs primarily metabolized by CYP3A may be associated with a mutual increase in their concentrations, which may increase or prolong both therapeutic and side effects. HMG-CoA reductase inhibitors (statins): if co-administration is necessary, it is recommended to take the lowest dose of a statin, it is necessary to use statins that are independent of CYP3A metabolism. Indirect anticoagulants: when warfarin and clarithromycin are taken together, bleeding is possible, a pronounced increase in INR and prothrombin time. Full information on drug interactions is provided in the instructions for use.

Special instructions:

Influence on the ability to drive vehicles and engage in other potentially hazardous activities that require increased concentration of attention and speed of psychomotor reactions:

the potential for dizziness, vertigo, confusion and disorientation that may occur while taking this drug should be taken into account. Care should be taken when driving vehicles and engaging in other potentially hazardous activities that require an increased concentration of attention and speed of psychomotor reactions.

New generation antibiotics are very effective and have fewer contraindications and side effects than their predecessors. In the article we will consider what a bright representative of such medicines is, its characteristics, indications and contraindications, reviews. "Klacid" is an antibiotic, which will be discussed below.

Manufacturer, release form, main active ingredient

The drug "Klacid" is produced by the company "Abbott Laboratories" in Italy, the USA or France. It is produced in the form of tablets of 250 or 500 mg or in the form of a powder from which to prepare a suspension - it is especially convenient to give it to young children. The main active ingredient is claritomycin. It is effective in combating many types of bacteria, the drug is used mainly for the treatment of respiratory tract infections, skin diseases, as well as for the prevention of stomach ulcers. More details about the indications for the use of the drug "Klacid" will be discussed later.

For what diagnoses is the medical preparation "Klacid" used?

Indications for the appointment of this medication are as follows:

inflammatory diseases of the respiratory tract (upper) of an infectious nature (for example, the antibiotic "Klacid" treats almost all diseases of the upper respiratory tract, be it pharyngitis, sinusitis, bronchitis, and so on);
it is prescribed for the treatment of skin diseases, including erysipelas, inflammation of the subcutaneous tissue, folliculitis;
the drug is used to treat acne;
the medication is prescribed to prevent relapses - repetitions of exacerbation of duodenal ulcers.

This antibiotic is used to treat even young children. They are prescribed the drug in the form of a suspension. The manufacturer produces a powder for its preparation with various fruit flavors, so it is relatively easy for a mother to give this medicine to a child, which is often why many parents give positive feedback to this medicine. "Klacid" according to indications is used for the treatment of very small children - children from 6 months.

Contraindications to the use of the drug, side effects

This antibiotic has a number of contraindications for use, among them are the following:

severe renal failure;
hypersensitivity to the components that make up the drug;
with caution, the drug "Klacid" should be prescribed to patients who have problems with the kidneys and liver;
the drug is contraindicated in pregnant women and women during lactation.

Judging by the reviews, the drug "Klacid" rarely causes any side effects, but some people may experience the following undesirable manifestations:

nausea, vomiting, abdominal pain;
discoloration of the tongue and teeth, stomatitis;
deterioration of the liver;
candidiasis in the mouth;
headaches, anxiety, insomnia, dizziness.

Again, this drug, which belongs to the latest generation of antibiotics, does not often cause unpleasant consequences. Please note that the dosage of the drug for children depends on the weight of the child and the diagnosis, the doctor must calculate the volume. Adults are also not recommended to self-medicate, it is important to know that the maximum dose of the drug per day is 500 mg.

What do they say about the drug? Reviews. "Klacid" - the opinions of patients with a "plus" sign

So, doctors and patients unanimously note that this antibiotic is quite effective for the treatment of diseases that were listed in the indications for use. The course of its reception rarely lasts more than five days. The drug receives the following reviews:

"Klacid" really quickly helps to cope with infectious ENT diseases, many patients noted improvements already on the first day of taking it;
it is convenient to use: as a rule, you need to drink only one tablet per day (the drug intake does not depend on food intake);
the drug rarely causes side effects from the gastrointestinal tract and central nervous system.

Negative Feedback

Klacid, produced abroad (there are also Russian analogues), is quite expensive - from 800 to 1000 rubles per package of 14 tablets of 500 mg;
the medication should be used with extreme caution if the patient has any problems with the liver, and, unfortunately, a large number of people have them;
also carefully recommend the use of the drug for the treatment of children and the elderly, as well as for people with weakened immune systems;
kids need to buy a powder for preparing a suspension, and it is not sold in every pharmacy.

Features of the use of drugs in children. Characteristics of Parents and Pediatricians

The drug "Klacid" for children receives mostly positive reviews, although many pediatricians warn parents against self-administering the remedy to the child. Remember: the doctor must prescribe the antibiotic, as well as calculate its dosage. Here is what those who used the drug "Klacid" in the form of a suspension for the treatment of children say:

99% of parents note that the child drinks this drug with pleasure or without any problems, since the manufacturer produces a product with a variety of fruit flavors, it can also be added to juice or milk;
the medication effectively copes with the treatment of diseases according to indications, however, children are prescribed it only in extreme cases, when other medicines do not help.

Conclusions and conclusion

Please note that while taking the drug "Klacid", the child may experience abdominal pain, nausea, vomiting, restlessness. The fact is that the baby's immunity, especially against the background of the disease, is suppressed, and the gastrointestinal tract is not sufficiently adapted to take such strong drugs. When such reactions appear, especially if you see that the child is getting worse and worse, you should immediately contact your pediatrician. The remedy "Klacid" (suspension) rarely receives reviews of this kind, yet this antibiotic really successfully copes with severe cases of ENT infections and skin problems. If earlier the treatment of such diseases was complex and protracted, now a 5-7-day intake of the named drug is often enough.

The antibiotic Klacid contains an active ingredient, as well as additional components: sodium calcium alginate, sodium alginate, lactose, anhydrous citric acid hydrogen phosphate, stearic acid, povidone KZO, magnesium stearate.

Release form

Klacid 500 mg and 250 mg is produced in the form of tablets, which are coated with a yellow shell. The tablets are oval in shape, the presence of two layers is noted along the cut: a yellow film and a whitish core. A blister made of foil can hold 7, 10 or 14 tablets, 1, 2 or 3 such blisters are packed in a cardboard box.

pharmachologic effect

Active substance clarithromycin belongs to the group of macrolides, semi-synthetic. The antibacterial effect is produced by suppressing the bacterial protein synthesis. The consistency of the tablet is such that the active ingredient is released gradually as the drug passes through the gastrointestinal tract. Clarithromycin active against isolated and standard cultures of bacteria. A high effect is noted when using the agent for the treatment of legionnaires' disease, pneumonia of mycoplasmal etiology. Gram-negative bacteria are not sensitive to clarithromycin .

The active substance acts as an antibacterial agent against group A streptococci , pneumococcus , golden staphylococcus , microorganism pathogens hemophilic infection , listeriosis , pneumonia , pneumochlamydiasis , leprosy , , faces , sporotrichosis.

Those pathogens that do not show sensitivity to and Methicillin , are also resistant to clarithromycin .

There has also been a positive impact clarithromycin in relation to the following microorganism (efficacy and safety has not been confirmed in the course of clinical trials): green streptococcus, peptococcus, group B, C, F, G streptococci; causative agents of pasteurellosis in birds, human toxicoinfections, , borreliosis, enterocolitis.

During the metabolism clarithromycin the body releases active 14-hydroxyclarithromycin, which exhibits microbiological activity. Metabolism occurs in the human liver. If a person took the drug regularly, there was no increase in the activity of its influence.

Pharmacokinetics and pharmacodynamics

Substance clarithromycin binds well to blood proteins. The highest concentration of the drug is determined within 6 hours. The larger the dose of the drug taken by the patient, the longer the period of time it is excreted from the body. The amount of the metabolite (14-hydroxyclarithromycin) does not increase in parallel with an increase in the dose of clarithromycin. The greater the accepted dose of Klacid, the less 14-hydroxyclarithromycin is formed in the body.

The drug is excreted from the body through the kidneys and intestines (respectively, 40% and 30% of the dose). After oral administration, clarithromycin and its metabolite are distributed to tissues and body fluids, tissues typically contain twice as much drug as serum.

Dosage adjustment is not required for liver diseases. With kidney disease, the elimination period clarithromycin from the body increases. Also, the elimination period of the drug increases in the elderly.

Indications for use

The use of the drug Klacid is indicated for the following diseases and conditions:

infectious diseases of the respiratory tract, lower sections ( pneumonia , and etc.);
infectious diseases of the respiratory tract, upper sections (with, etc.);
infectious lesions of soft tissues, skin ( folliculitis , erysipelas and etc.);
mycobacterial infections caused by Mycobacterium intracellulare and Mycobacterium avium;
infections provoked by Mycobacterium fortuitum, Mycobacterium chelonae, Mycobacterium kansasii.

It is also practiced to take the remedy to prevent infection provoked by the Mycobacterium avium complex (MAC). It is prescribed to reduce the frequency of manifestations of recurrences of duodenal ulcers.

Contraindications

Do not take an antibiotic in the following cases:

with the body to the means of the macrolide group;
at porphyria ;
during pregnancy and breastfeeding ;
children up to 3 years of age.

Carefully, the remedy is prescribed for violations of the kidneys and liver.

Can't be taken at the same time clarithromycin and such medicines: Dihydroergotamine , pimozide , Erhotamine , BUTstemizol .

Side effects

If Klacid is administered intravenously or taken orally, a number of side effects may occur. If such effects occur after intravenous administration or oral administration of tablets, it is necessary to inform the specialist about this. The following manifestations are possible:

CNS functions : change in taste, .
Digestive system : nausea , stomach ache, .
Local reactions with the introduction of the solution : inflammation at the injection site, phlebitis , pain during palpation.
Laboratory indicators : increased activity of liver enzymes.

In addition to these side effects, side effects that occur less frequently are possible:

oral cavity;
thrombocytopenia , leukopenia ;
hypoglycemia ;
mental disorders,;
, convulsions ;
myalgia ;
reversible hearing loss;
ventricular;
stomatitis , spicy , ;
liver dysfunction;
increased levels of creatinine in the blood.

Instructions for use Klacid (Method and dosage)

Instructions for the use of Klacid for children and adults provide for oral administration, regardless of the meal.

Adult patients are shown taking 250 mg of clarithromycin twice a day. If severe diseases, mycobacterial infections are being treated, the dose may be increased to 500 mg twice a day. In most cases, treatment lasts from 5 to 14 days.

If prescribed for treatment suspension Klacid instructions for use must be followed exactly. The suspension is prescribed for the treatment of children, it can be taken regardless of food intake, it can be taken with milk. To prepare the suspension for use, you need to gradually add water to the vial to the mark, then shake. 5 ml of a 60 ml suspension contains 125 mg of clarithromycin; 5 ml of a 100 ml suspension contains 250 mg of clarithromycin. The suspension can be stored for two weeks at room temperature.

Before giving the antibiotic Klacid to children, you need to shake the suspension thoroughly. A day is recommended for children to use a dose of 7.5 mg per 1 kg of body weight twice a day. The highest allowable dose is 500 mg twice a day. Therapy can last from 5 to 10 days.

Overdose

When taking very large doses of this drug, patients may show signs of impaired functioning of the digestive system. It is important to remove the remnants of the drug from the gastrointestinal tract as soon as possible, after which symptomatic treatment is carried out.

Interaction

Combination is strictly not allowed. clarithromycin and drugs Astemizol , pimozide , Terfenadine , Cisapride , as in this case, the development of serious side effects is likely. In particular, the manifestation of cardiac arrhythmias, including ventricular fibrillation, ventricular tachycardia, is possible.

Concomitant use of clarithromycin and Ergotamine or probably acute poisoning with ergotamines. In particular, ischemia of the extremities, vascular spasm, etc. may occur. Simultaneous administration of clarithromycin and ergot alkaloids is not allowed.

CYP3A inducers induce the metabolism of clarithromycin. As a result, the concentration of clarithromycin and its effectiveness decreases. If clarithromycin is used concomitantly, the plasma concentration increases Rifabutina and the concentration of clarithromycin decreases.

Preparations Nevirapine , Efavirenz , Rifabutin , Rifapentine able to accelerate the metabolism of clarithromycin, thereby reducing its plasma concentration and increasing the concentration of its metabolite - 14-OH-clarithromycin. As a consequence, therapeutic efficacy may decrease.

Decreased concentration clarithromycin observed when taken together with etravirine .

It is necessary to adjust the dose of drugs when co-administered clarithromycin and ritonavir .

With simultaneous treatment with Klacid and oral hypoglycemic drugs or insulin, severe hypoglycemia may occur. Glucose levels should be constantly monitored.

When taking antibiotics concomitantly with quinidine , disopyramide possible ventricular tachycardia.

With caution, clarithromycin should be taken by those who receive drugs - substrates of the CYP3A isoenzyme, as well as in combination with statins.

Concomitant treatment with clarithromycin and is contraindicated.

It is important to monitor the patient's condition during joint treatment and clarithromycin due to the risk of bleeding.

When taking clarithromycin and , there is a need to reduce the dosage of the latter drugs.

Simultaneous treatment with antibiotics and or carbamazepine leads to an increase in the concentration of these drugs in the bloodstream.

When using clarithromycin and triazolam likely to affect the central nervous system, as a result, drowsiness and confusion develop.

People who have impaired liver or kidney function should not take clarithromycin and colchicine at the same time.

With simultaneous treatment with clarithromycin, the effect of the latter is enhanced. It is necessary to constantly monitor the level of digoxin in the blood serum.

There is a bidirectional effect of drugs while taking clarithromycin and atazanavir , as well as clarithromycin and itraconazole, clarithromycin and saquinavir .

When treated simultaneously with an antibiotic and, diltiazem increases the likelihood of developing arterial hypotension.

Terms of sale

In pharmacies, the antibiotic is sold by prescription.

Storage conditions

It is necessary to protect the antibiotic from the access of children, it should be stored at a temperature not exceeding 30 ° C.

Best before date

The shelf life of the antibiotic is 3 years.

special instructions

In people with liver disease, there may be a change in the levels of serum enzymes, from which tablets should be prescribed carefully.

Caution is given to people taking other drugs that are metabolized by the liver in parallel.

With prolonged treatment with antibiotics, the formation of colonies with a large number of insensitive fungi and bacteria is possible.

In chronic liver diseases, serum enzymes should be regularly monitored.

Possible manifestation pseudomembranous colitis during antibiotic treatment. It is also possible to change the normal intestinal microflora.

Caution should be given to people with severe heart failure, bradycardia, hypomagnesaemia. It is necessary to constantly monitor the ECG, determining the increase in the QT interval.

May increase symptoms in people who take clarithromycin.

The powder for the preparation of a suspension of Klacid contains sucrose, which should be taken into account by people suffering.

In the treatment of clarithromycin, you need to carefully manage transport and perform activities that require a high concentration of attention.

Synonyms

Clarithromycin

Klacid's analogs

Coincidence in the ATX code of the 4th level:

Klacid's analogues are agents that belong to the same group and have an active substance similar to Klacid. These are medicines Clarexide , Binocular , Claricite , Clarithrosin , Clarithromycin , Claromin etc. You can replace the drug only after the approval of the doctor, since each of these drugs has certain features of use and side effects.

The price of analogues can be either higher or lower. Differences Klacid and Klacid SR in that the latter drug is a prolonged-release drug, that is, the active substance is released more slowly.

With alcohol

According to the instructions, Klacid and alcohol are incompatible. If the patient consumes alcohol during treatment with this antibiotic, the risk of side effects increases dramatically, since the toxicity of the drug greatly increases.

Klacid for children

Klacid for children can be used from the age of three. In most cases, children are prescribed Klacid suspension. Reviews for children indicate that this drug is quite effective. At the same time, the price of the suspension is quite high. The dosage for children is as follows: 7.5 mg of the drug per 1 kg of the child's weight twice a day. The largest daily dose is 500 mg.

Children who are already 12 years old are prescribed 250 mg (tablets) twice a day. There is evidence that children tolerate Klacid more easily than other antibiotics. Therefore, the drug is often prescribed for , bronchitis , pneumonia etc. However, we should not forget that side effects still occur.

During pregnancy and lactation

There is no precise information on the safety of using Klacid for treatment. and nursing mothers. Therefore, the use during the period of gestation is not practiced.

Every time a pediatrician prescribes an antibiotic for a child, the mother has many questions. How effective is the drug? Will strong medicine harm the child? How to correctly calculate the dose so that the antibiotic works, but does not cause side effects? Of particular concern are new drugs, such as Klacid, which has recently appeared on the pharmaceutical market. Our review will help you, parents, draw conclusions about the appropriateness, effectiveness and possible consequences of its use.

Klacid does not kill pathogens, but deprives them of the opportunity to multiply. This is enough for recovery.

Features of the drug

Modern powerful drug Klacid belongs to the class of macrolides - the least toxic, and therefore the safest antibiotics. A similar action of a wide spectrum has a long-familiar and familiar Erythromycin. However, as evidenced by numerous reviews on parent forums, Klacid for children is a more effective and convenient tool. A new generation antibiotic, unlike its predecessor, has a relatively pleasant taste and fruity aroma. And this is important when the baby does not yet understand the purpose of stuffing him with bitter medicine. In addition, you need to take it only two, not four times a day, which reduces the risk of side effects and the negative effect of the drug on the delicate children's body.

Recently, microbes and pathogens have managed to adapt to antibiotics such as penicillin and cephalosporin, losing sensitivity to them. In this regard, Klacid often turns out to be one of the most effective and at the same time sparing options.

Suspension is the most convenient dosage form for children.

The drug is produced by Abbott Laboratories Limited (UK). The price of a medicine in the form of a powder for the preparation of suspensions varies between 300-400 rubles. A: The larger the dosage, the higher the cost. Tablets can be bought on average for 600-800 rubles. Their cost also depends on the dosage and the number of tablets in the pack.

Analogues

The drug has a number of analogues, which include the same basic substance - clarithromycin. These include Klarbakt, Clarithromycin, Fromilid, Exoterin and some others. The possibility of interchangeability of drugs in each case can only be confirmed by a pediatrician.

When is this medicine prescribed - indications for use

For children, the remedy is prescribed for inflammatory processes in the body caused by a large number of varieties of microbes. The appointment of the drug is advisable when there are:

typically childhood infections - scarlet fever, whooping cough;
diseases of the lower respiratory tract - lung abscess, pneumonia, bronchitis;
upper respiratory tract infections - tonsillitis,;
ENT diseases - otitis media;
gonorrheal or chlamydial nature;
ulcerative lesions of the stomach and duodenum (the medicine is used here as part of complex therapy);
infections of the skin (for example, erysipelas) and soft tissues.

A more detailed list of problems eliminated by Klacid is given in the instructions for its use, which can be.

Klacid: variety of forms

The antibiotic is produced in the form:

tablets;
powder for the preparation of a suspension taken orally;
powder for the preparation of a suspension used for infusions (droppers).

Children under the age of three years Klacid in the form of tablets is not prescribed.

Of course, in the case of pediatric patients, it is better to opt for the Klacid suspension: its semi-liquid consistency is the most convenient and pleasant for babies.

Many parents naturally have a question: what do the markings on the packages mean: 125, 250, 500? These figures indicate the amount of the active substance clarithromycin contained in one tablet or 5 ml of the prepared suspension. For example, if it is Klacid 125 powder, then 5 ml of suspension (about a teaspoon) contains 125 ml of the active ingredient. This information is important for the correct calculation of the dosage corresponding to the weight and age of the child.

The powder is available in vials (60 and 100 ml), in which the suspension is convenient to store and dilute.

Operating principle

Klacid acts extremely gently and sparingly: he does not kill pathogenic bacteria, but deprives them of the possibility of reproduction. In this case, the drug has a prolonged effect. Even after the end of the intake, it continues to be in the body for some time and perform its function, inhibiting the growth of microbes.

The effectiveness of the drug is also explained by its ability to accumulate in the same places where 99% of pathogens are usually concentrated - in the lungs and bronchi. At the same time, the antibiotic, unlike its predecessors, has a pronounced anti-inflammatory effect.

Suspension preparation and dosage calculation

Preparing the suspension is simple: just add water to the vial up to the risk and shake the liquid vigorously until the powder granules are completely dissolved. The result should be a white (or almost white) opaque liquid, which can be stored at room temperature (not higher than 30 degrees and away from sunlight) for about two weeks.

Shake the bottle before each use.

Before giving Klacid to a child, carefully read the instructions. The main criterion for the correct dosage is the weight of the patient. The medicine is given at the rate of 7.5 ml per 1 kg of the patient's body weight.

The numbers that complement the name of the medicine are also important. Children are usually prescribed suspensions of Klacid 125 or Klacid 250. The suspension drug is prescribed even to patients under two years of age in doses appropriate for age.

Consider the option of calculating the dosage of the drug Klacid 250 using a specific example.

The patient is a boy Egor, 8 years old. The child's weight is 25 kg. Therefore, for one dose (assuming the drug is taken twice a day), he needs an amount of syrup that would contain 187.5 ml of clarithromycin: 25 kg × 7.5 ml of the recommended dose per 1 kg of body weight. If the drug has a concentration of 250, then 5 ml contains 250 ml of the active substance, i.e. 1 ml of suspension contains 50 ml of clarithromycin (250 ml/5 ml). It turns out that Egor needs to take 3.75 ml of the suspension (187.5 ml / 50 ml - the dose of clarithromycin necessary for a particular child / the content of clarithromycin in 1 ml of the resulting syrup). This is 0.75 teaspoon, i.e. about 3/4.

The medication is taken twice a day. It is better to do this in the morning and in the evening at about the same time. Before or after a meal, it doesn't matter. A small child can be given a suspension along with milk.

You can add the suspension to milk.

The course lasts from 5 to 10 days. A specific scheme, depending on the severity of the disease and the patient's response to the medicine, is made by a pediatrician. If there is no improvement within three days, the drug is canceled, and an adequate replacement is selected for it.

The maximum allowable daily dose of the drug in any case is 500 ml.

It is important to know the symptoms of an overdose of Klacid:

dizziness;
mental changes, in particular, the appearance of signs of paranoia.

The listed signs are the basis for stopping the drug and carrying out procedures aimed at removing the patient from the dangerous state of overdose:

removal from the stomach of the remnants of the drug that did not have time to be absorbed by taking activated charcoal;
peritoneal dialysis;
hemodialysis.

Side effects and contraindications

Klacid should be used with caution (or even stop using it) in children with problems with the liver, kidneys and biliary tract. The components of the drug with dysfunction of these organs are poorly excreted and accumulate in the body, overloading it. The same applies to young patients suffering from arrhythmia and increased anxiety, since the drug provokes the release of adrenaline. It is important for parents of allergic and asthmatic children to know that Klacid slows down the withdrawal of antihistamines from the body. If a child takes antiallergic drugs constantly, during treatment with macrolides, their components may accumulate in excessive (toxic) doses. Be careful not to get poisoned.