Gdclar 250

Description

Gdclar 250 is prescribed to treat a variety of bacterial infections. These include:

• Respiratory tract infections: Such as pharyngitis, tonsillitis, acute maxillary sinusitis, acute bacterial exacerbation of chronic bronchitis, and pneumonia (including community-acquired pneumonia and legionellosis).
• Skin and soft tissue infections.
• Leprosy.
• Peptic ulcer disease: Especially when caused by Helicobacter pylori. It’s often used as part of a multi-drug treatment plan.
• Lyme disease.
• Acne.

How Do You Take It?

The exact dosage depends on the specific infection and the patient’s age. Always follow your doctor’s instructions carefully.

Adult Dosing (Oral)

• Acute Exacerbation of Chronic Bronchitis: Typically 250-500 mg by mouth every 12 hours for 7-14 days. An extended-release form might be 1000 mg once daily for 7 days.
• Mycobacterial Infection (Prophylaxis and Treatment): Usually 500 mg by mouth every 12 hours for 7-14 days, often in combination with other anti-mycobacterial drugs like rifampin and ethambutol.
• Peptic Ulcer Disease: 500 mg by mouth every 8-12 hours for 10-14 days. This is given as part of a 2- or 3-drug combination regimen (e.g., with bismuth subsalicylate, amoxicillin, an H2 receptor antagonist, or a proton pump inhibitor).
• Pharyngitis, Tonsillitis: 250 mg by mouth every 12 hours for 10 days.
• Community-Acquired Pneumonia, Skin/Skin Structure Infection: 250 mg by mouth every 12 hours for 7-14 days. The extended-release form might be 1000 mg once daily for 7 days.
• Endocarditis Prophylaxis: 500 mg by mouth 30-60 minutes before a surgical procedure.

Adult Dosing (Intravenous)

• Respiratory Tract Infections; Skin and Soft Tissue Infections; Susceptible Infections: 500 mg twice a day for 2-5 days, infused over 60 minutes using a 0.2% solution. Your doctor will switch you to oral therapy as soon as possible.

Adult Dosing (Topical)

• Apply a thin layer to the affected area once daily.

Child Dosing (Oral)

• 15 mg/kg per day, with a maximum of 1 gram per day, given every 12 hours.

Renal Impairment

• If your creatinine clearance (CrCl) is less than 30 ml/min, your dosage may need to be halved or the dosing interval doubled.

Administration

• Standard release tablets and oral suspension: You can take these with or without food.
• Extended-release (XL) and modified-release (MR) tablets: These must be taken with food. Swallow them whole; do not chew or crush them.

Important Considerations

Contraindications (When NOT to take it)

• If you have a known hypersensitivity to clarithromycin or other macrolide antibiotics.
• If you are currently taking medications like terfenadine, astemizole, pimozide, cisapride, or ergot derivatives (e.g., ergotamine).
• During pregnancy.
• If you have a history of acute porphyria.

Precautions

• Use with caution if you have kidney or liver impairment.
• Be aware of the potential for macrolide cross-resistance (meaning resistance to clarithromycin might imply resistance to other macrolides).
• Lactation: Clarithromycin is excreted in breast milk, so use with caution if you are breastfeeding.
• Children: Use with caution as directed by a physician.

Drug Interactions

Clarithromycin can interact with many other medications, potentially altering their effects or increasing the risk of side effects. Some important interactions include:

• Reduced efficacy of clarithromycin: This can occur with CYP3A inducers (e.g., phenytoin, carbamazepine, efavirenz, rifampicin).
• Increased levels/toxicity of other drugs: This can happen with ritonavir, quinidine, disopyramide, sildenafil, tadalafil, vardenafil, digoxin, verapamil, HMG-CoA reductase inhibitors (statins), oral hypoglycemic drugs (e.g., pioglitazone), insulin, oral anticoagulants, aminoglycosides, and triabenzodiazepines (e.g., midazolam).
• Bi-directional drug interactions: These can occur with atazanavir, itraconazole, or saquinavir.
• Potentially Fatal Interactions:
  • Concurrent use with ergot alkaloids (e.g., ergotamine or dihydroergotamine): This can lead to acute ergot toxicity, characterized by vasospasm and ischemia of the extremities.
  • Concomitant use with astemizole, cisapride, pimozide, and terfenadine: This may result in QT prolongation or serious ventricular cardiac arrhythmias.