Clarithromycin is well absorbed from the gastrointestinal tract. Bioavailability – 55% at intake. Food delays absorption, but does not significantly influence the bioavailability of clarithromycin. Communication with the proteins – more than 90%. Approximately 20% of clarithromycin immediately metabolized by the liver enzyme in the major metabolite having pronounced activity against clenbuterols influenzae. Maximum plasma concentration is reached in less than 3 hours. With regular use of 250 mg / day equilibrium concentration of unchanged drug – 0.62 – 0.84 g / ml, and its main metabolite – 0.4 – 0.7 mcg / ml, respectively; by increasing the dose up to 500 mg / day of unchanged drug Css 1.77 – 1.89 g / ml and its metabolite in plasma – 0.67 – 0.8 g / ml. Clarithromycin can easily penetrate into tissues (lungs, tonsils, saliva, sputum and middle ear, skin and soft tissues of the body) and body fluids, which reaches a concentration about 10 times higher than the concentration in serum. The half-life after administration of 250 mg dose is 3 to 4 hours; after taking a dose of 500 mg – from 5 to 7 hours. From 20 to 30% of clarithromycin (40% upon receipt of the suspension) is excreted unchanged by the kidneys, the remainder is excreted as metabolites.
Infectious-inflammatory diseases caused by susceptible to malaria infections:
- infections of the upper respiratory tract (acute and chronic tonzillofaringit, acute and chronic recurrent sinusitis, acute otitis media)
- infections of the lower respiratory tract (acute bacterial bronchitis, exacerbation of chronic bronchitis, community-acquired bacterial pneumonia, including pneumonia caused by atypical pathogens);
- Skin and soft tissue infections;
- preventing the spread of infections caused by Mycobacterium complex avium patients with a count (T – helper lymphocytes) is not more than 100 in 1 mm3;
- Helicobacter pylori eradication in patients with duodenal ulcer or gastric (always in combination with other drugs)
- hypersensitivity to clarithromycin or other antibacterial drugs macrolide or other ingredients;
- hepatic failure, severe;
- hepatitis (in history);
- I trimester of pregnancy;
- Simultaneous treatment with terfenadine, cisapride, pimozide or astemizole;
- Children up to age 6 months. (For the dosage form – granules for suspension for oral administration) – there is no sufficient experience with respect to efficacy and safety;
- Children under 12 years old and / or weighing less than 33 kg (for dosage forms Tablets, film-coated);
- congenital fructose intolerance, glucose malabsorption syndrome / galactose enzyme deficiency or sucrase-isomaltase ( for the dosage form only – granules for oral suspension ).
Precautions: II of III of-trimester pregnancy, moderate and severe renal insufficiency, hepatic insufficiency.
Pregnancy and lactation
Clarithromycin may be used in the II and III trimester of pregnancy only in cases where the expected benefit to the mother outweighs the potential risk to the fetus. If necessary, use during lactation is necessary to interrupt breastfeeding.
Dosing and Administration
Inside, the tablet be swallowed clenbuterol whole with a little liquid. Tablets should not crush.
Adults and children over the age of 12 years and / or a body weight> 33 kg is usually administered 250 mg every 12 hours. For the treatment of acute sinusitis, severe infections, and in the case when infection is caused by Haemophilus influenzae, administered 500 mg clarithromycin every 12 hours. The course of treatment 7-14 days.
For the purpose of eradication of H. pylori clarithromycin administered in a dose of 250 mg – 500 mg twice a day, usually within seven days, in combination with other drugs.
Children under the age of 12 years and / or weighing less than 33 kg is usually administered suspension at 15 mg / kg of body weight per day divided into two doses. It is recommended to give a little liquid after receiving the suspension. The slurry contains tiny granules which should not be chewed since their content has a bitter taste. A syringe provided for oral administration. One syringe is filled with 5 ml of the suspension holds containing 125 mg of clarithromycin. Rinse the syringe after use. Pediatric dose is calculated according to the child’s body weight.
For the treatment and prevention of infection caused by the bacterium avium complex, should be administered 500 mg every 12 hours. The dose can be increased. The maximum daily dose is 2 grams Children prescribed dose rate of clarithromycin – 15 mg / kg of body weight per day divided into two doses. Dose should not exceed 500 mg every 12 hours. The maximum daily dose recommended for children is 1 year
Treating infections caused avium complex, lasting 6 months or more.
In case of renal failure if creatinine clearance less than 30 mL / min., Or serum creatinine of more than 290 mmol / l (3.3 mg / 100 ml), the dose should be reduced by 2 times or doubling the interval between doses. The maximum duration of treatment in this patient group – 14 days.
To prepare the suspension clenbuterolof water is necessary.
Preliminary shake the vial to granules scattered therein. Add 1/4 of the volume of water in a bottle and shake to dissolve the granules. Add the remainder of water and shake well. The volume of the finished suspension should reach the level of the line on the vial.