Clarithromycin

Benjamin Clanner-Engelshofen is a freelance writer in the medical department. He studied biochemistry and pharmacy in Munich and Cambridge / Boston (USA) and noticed early on that he particularly enjoyed the interface between medicine and science. That is why he went on to study human medicine.

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The active ingredient clarithromycin belongs to the group of macrolide antibiotics and is mainly used to treat bacterial infections of the respiratory tract, ears and skin. It is usually taken in tablet form once or twice a day. Clarithromycin side effects may include digestive problems, insomnia, and headaches. Here you can read everything you need to know about the effects and side effects of clarithromycin, dosage and use.

This is how clarithromycin works

The active ingredient clarithromycin penetrates the bacterial cells and prevents them from producing proteins. The bacteria are not killed by the antibiotic, but only inhibited in their growth - the active ingredient has a bacteriostatic effect. This inhibition of the growth of the bacteria gives the immune system the opportunity to contain the infection.

Compared to erythromycin, another well-known macrolide antibiotic, clarithromycin is effective against even more bacteria. In addition, unlike erythromycin, it is stable to gastric acid, so it does not break down in the stomach. In addition, it is better tissue-accessible, so it reaches its goal in the body much better.

Clarithromycin is quickly and completely absorbed into the blood in the intestine. Some of the antibiotic is metabolized in the liver. About four hours after ingestion, half of the active ingredient is excreted, about three quarters in the stool and a quarter with the urine.

When is clarithromycin used?

The active ingredient clarithromycin is used against bacterial infections with pathogens sensitive to clarithromycin, i.e. pathogens that can be inhibited in growth by the antibiotic. These infections often include respiratory infections (such as pneumonia and bronchitis), ear, nose and throat infections (such as tonsillitis, sinus infections, and throat infections), and skin infections (such as wound infections, hair follicle infections, and skin rose).

The application must be carried out exactly as instructed by the doctor or pharmacist. If used for too short or too long, there is a risk of developing resistance, i.e. the bacteria become insensitive to clarithromycin. If therapy is discontinued prematurely, it can also lead to a relapse.

This is how clarithromycin is used

The active ingredient clarithromycin is usually used in the form of tablets. Clarithromycin juice and granules for oral suspension are also available for patients who have difficulty swallowing or who are tube-fed. Delayed-release tablets (prolonged-release tablets) are also available. In contrast to normal tablets, they only have to be taken once a day.

The usual duration of use is six to 14 days, depending on the severity of the infection. The clarithromycin dosage is 250 milligrams of clarithromycin twice a day. However, if the infection is severe, the doctor can double this dose.

Clarithromycin should be used for the entire duration of treatment prescribed by the doctor. Even if the symptoms improve beforehand, the patient must not stop taking it himself (risk of developing resistance and relapse!).

Clarithromycin is used in combination with another antibiotic and a proton pump inhibitor (used to reduce the production of acid in the stomach) to treat Helicobacter pylori infection (a bacterium that can cause stomach ulcers). This triple therapy is only intended for this specific infection.

What are the side effects of clarithromycin?

Clarithromycin side effects occur in every tenth to hundredth person treated with insomnia, taste disturbances, headache, diarrhea, vomiting, nausea, indigestion, altered liver values, increased sweating and skin rashes.

The side effects in the digestive tract arise from the fact that the antibiotic also works against the beneficial intestinal bacteria. This affects digestion.

What should be considered when taking clarithromycin?

The active ingredient clarithromycin has similar interactions as other macrolide antibiotics, for example erythromycin. Since it is broken down in the liver by an enzyme that also breaks down other drugs, there can be mutual interference. If they are taken at the same time - even at different times of the day - levels of active ingredients that are too low or too high can arise in the body. The affected drugs then either do not work at all or accumulate so much in the body that toxic effects occur. The simultaneous use of clarithromycin and such active ingredients should therefore be discussed in advance with your doctor or pharmacist.

Examples of such active ingredients are:

Oral diabetes drugs (antidiabetic drugs) such as pioglitazone, repaglinide, rosiglitazone
Statins (cholesterol-lowering drugs) such as lovastatin, simvastatin
Migraine drugs such as ergotamine
Anti-fungal agents (antifungal agents) such as fluconazole, ketoconazole
Heart medications like digoxin, verapamil, nifedipine
Erectile dysfunction agents such as Sildenafil, Tadalafil, Vardenafil, Avanafil

Clarithromycin may already be used in newborns (in a correspondingly low dose). Elderly people can also take the antibiotic unless they have liver problems.

If the doctor considers it absolutely necessary, the antibiotic can also be used during pregnancy and breastfeeding.

How to get clarithromycin medication

Clarithromycin requires a prescription in every dosage and can only be obtained from pharmacies.

How long has clarithromycin been known?

Clarithromycin was developed based on the model of the antibiotic erythromycin in the 1970s by the Japanese pharmaceutical company Taisho Pharmaceutical. In 1980 the active ingredient was registered for a patent and marketed in Japan from 1991. Later in the same year, the antibiotic was approved in cooperation with the US pharmaceutical company Abbott Laboratories, first in the USA and later worldwide. In Europe, patent protection expired in 2004, in the USA in 2005. Many manufacturers then brought generics with the active ingredient clarithromycin onto the market.

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