Each tablet contains Clarithromycin, 500mg
It is given by mouth in usual doses of 250mg twice daily, increased to 500mg twice daily if necessary insevere infection. A course is usually for 7 to 14 days. In patients with severe renal impairement dosage may need to be haved to 250mg once daily or 250mg twice daily in severe infection.
Reports indicate that the ingestion of large amounts of Clarithromycin can be expected to produce gastro-instestinal symptoms. Adverse reactions accompanying overdosage should be treated by gastric lavage and general supportive measures. One patient who had a history of bipolar disorders ingested 8 grams of Clarithromycin and showed altered mental status, paranoid behavior, hypokalaemia. As with other macrolides, Clarithromycin serum levels are not expected to be appropriately affected by hemodialysis or peritoneal dialysis.
Clarithromycin is indicated for the treatment of mild to moderate infections caused by susceptible strains of designated microorganisms in the conditions listed: Upper respiratory tract in fections; Pharyngitis, Tonsilitis, Sinusitis and Otitis media. Lower respiratory tract infections: Pneumonia, Broncho-pneumonia, Acute bronchitis and Chronic bronchitis. Skin and soft tissue infections: Cellulitis, Pyodema and Cutaneous pustular lesion Disseminated mycobacterial infection due to Mycobacterium avium or Mycrobacterium intracellular. Clarithromycin in combination with omeprazole is indicated in the treatment in patients with an active duodenal ulcer associated with H. pylori. The eradication of H. pylori has been demonstrated to reduce the risk of duodenal ulcer recurrence.
Clarithromycin is contraindicated in patients with known hypersensitivity to clarithromycin, erythromycin or any of the macrolide antibiotics. Clarithromycin is contraindicated in patients receiving terfenadine therapy who have pre-existing cardiac abnormalities (arrhythmia, bradycardia, QT interval prolongation, ischemic heart disease, congestive heart failure) or electrolyte disturbances.
Caution is required in patients with impaired renal or hepatic function. It should not be used during pregnancy if possible: high doses have been associated with embryotoxicity in animal studies.
Ciprofloxacin is generally well-tolerated. The commonly reported side effects are diarrhea, vomiting, abdominal pain, headache, restlessness and rash. Other side effects reported very rarely are arthralgia, and increase in serum transaminase level.
Ciprofloxacin absorption when co-administered with magnesium-aluminum antacids. Other cations, such as calcium and probably zinc appear to interact in similar manner. Theophylline serum concentration have been found to be markedly elevated when co-administered with Ciprofloxacin. At doses used for systematic infections, Ciprofloxacin decreases theopylline clearance by approximately 30%. A decreased Ciprofloxacin absorption.
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