Maclar

Description

Maclar Tablet is prescribed to treat a wide range 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: Particularly when caused by Helicobacter pylori. It’s often used as part of a multi-drug regimen to eradicate the bacteria.
• Lyme disease.
• Acne.
• Middle ear infections (acute otitis media).
• Tooth and mouth infections.
• Mycobacterial infections (treatment and prophylaxis).

How Do You Take It?

The exact dosage and duration of treatment will be determined by your doctor based on the specific infection, its severity, and your individual health. Always follow your doctor’s instructions precisely.

Adult Dosing (Oral)

• Acute Exacerbation of Chronic Bronchitis: 250-500 mg by mouth every 12 hours for 7-14 days. An extended-release (XL) form may be 1000 mg once daily for 7 days.
• Mycobacterial Infection (Prophylaxis and Treatment): 500 mg by mouth every 12 hours for 7-14 days. This is typically used 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. It is administered as part of a 2- or 3-drug combination regimen, which may include 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. Extended-release may be 1000 mg once daily for 7 days.
• Endocarditis Prophylaxis: 500 mg by mouth 30-60 minutes before a surgical procedure.

Adult Dosing (Intravenous – for injectable forms, not Maclar Tablet)

• For respiratory tract, skin and soft tissue, and other susceptible infections: 500 mg twice daily for 2-5 days. It should be infused over 60 minutes using a 0.2% solution. Oral therapy should be initiated as soon as possible. (Note: Maclar is a tablet, so this section applies to injectable clarithromycin products.)

Adult Dosing (Topical – for topical forms, not Maclar Tablet)

• Apply a thin layer to the affected area once daily. (Note: Maclar is a tablet, so this section applies to topical clarithromycin products.)

Child Dosing (Oral)

• 15 mg/kg per day, with a maximum of 1 gram per day, given every 12 hours. (Note: Maclar 500mg may not be suitable for all pediatric doses; follow your doctor’s specific prescription.)

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 (like Maclar Tablet) & oral suspension: May be taken with or without food.
• Extended-release (XL) & modified-release (MR) tablets: Should be taken with food. Swallow whole, do not chew/crush.

Important Considerations

Contraindications (When NOT to take it)

• If you have a known hypersensitivity to clarithromycin, other macrolide antibiotics, or any components of the tablet.
• If you are currently receiving medications such as terfenadine, astemizole, pimozide, cisapride, and ergot derivatives (e.g., ergotamine or dihydroergotamine), as concurrent use can lead to serious and potentially fatal interactions (e.g., QT prolongation, acute ergot toxicity, severe cardiac arrhythmias).
• During pregnancy.
• If you have a history of acute porphyria.
• In patients with a history of QT prolongation (congenital or documented acquired) or ventricular cardiac arrhythmia, including torsades de pointes.
• In patients with hypokalemia or hypomagnesemia due to the risk of QT prolongation.
• If you have severe hepatic failure in combination with renal impairment.
• Concomitant use with specific HMG-CoA reductase inhibitors (statins) that are extensively metabolized by CYP3A4, such as lovastatin or simvastatin, due to the increased risk of myopathy, including rhabdomyolysis.
• Concomitant use with colchicine in patients with renal or hepatic impairment.

Precautions

• Use with caution if you have kidney or liver impairment. Dosage adjustments may be necessary.
• Be aware of the potential for macrolide cross-resistance (resistance to clarithromycin might imply resistance to other macrolides).
• Lactation: Clarithromycin is excreted into breast milk; use with caution. Consult your doctor.
• Children: Use with caution as directed by a physician. Maclar 500mg may not be suitable for all pediatric age groups; refer to pediatric suspension if required.
• Consider the possibility of pseudomembranous colitis if severe diarrhea develops during or after treatment.
• Clarithromycin may worsen symptoms of myasthenia gravis.
• Monitor for signs of QT prolongation if you have pre-existing cardiac conditions or are taking other QT-prolonging drugs.
• This medicine may cause dizziness or drowsiness; avoid driving or operating machinery if affected.