Select therapeutic use:
Indications for BIAXIN XL:
Mild to moderate susceptible acute maxillary sinusitis, acute bacterial exacerbation of chronic bronchitis, community-acquired pneumonia.
Swallow whole. Take with food. 1g once daily. Sinusitis: for 14 days. Bronchitis, pneumonia: for 7 days. Severe renal impairment (CrCl <30mL/min): reduce clarithromycin dose by ½. When moderate or severe renal impairment and concomitant atazanavir or ritonavir: reduce clarithromycin dose by ½ (CrCl 30–60mL/min) or ¾ (CrCl <30mL/min).
Concomitant cisapride, pimozide, ergots, HMG-CoA reductase inhibitors extensively metabolized by CYP3A4 (lovastatin or simvastatin). History of QT prolongation or ventricular cardiac arrhythmia (including torsades de pointes). Concomitant colchicine (in renal or hepatic impairment). Cholestatic jaundice/hepatic dysfunction with prior clarithromycin use.
Discontinue immediately if hepatitis or severe hypersensitivity reactions occurs. Severe renal impairment. Proarrhythmic conditions (eg, hypokalemia, hypomagnesemia, bradycardia); avoid. Myasthenia gravis. History of porphyria; avoid concomitant ranitidine bismuth citrate. Elderly. Pregnancy (Cat.C): usually not recommended. Nursing mothers.
See Contraindications. Class IA (quinidine, procainamide) or Class III (dofetilide, amiodarone, sotalol) antiarrhythmics: not recommended. Sildenafil, tadalafil, vardenafil: not recommended. Antagonized by CYP3A inducers (eg, efavirenz, nevirapine, rifampicin, rifabutin, rifapentine, etravirine); use alternative antibacterial treatment. Doses >1000mg/day should not be coadministered with protease inhibitors. Separate zidovudine dose by at least 2hrs. Potentiated by CYP3A inhibitors (eg, itraconazole, saquinavir, atazanavir, ritonavir). Concomitant atazanavir: see Adults; consider alternative antibacterial therapy for indications other than MAC. May potentiate theophylline, omeprazole, phenytoin, digoxin, midazolam, alprazolam, triazolam, cyclosporine, hexobarbital, tacrolimus, alfentanil, disopyramide, bromocriptine, valproate, carbamazepine, tolterodine, itraconazole, methylprednisolone, cilostazol, vinblastine, quetiapine; monitor these and other drugs metabolized by CYP3A. Myopathy/rhabdomyolysis with statins; max 20mg atorvastatin/day, 40mg pravastatin/day; consider use of statin not dependent on CYP3A metabolism (eg, fluvastatin). Reduce colchicine dose if coadministration is necessary. Hypoglycemia with oral hypoglycemics/insulin; carefully monitor glucose. Oral anticoagulants: frequently monitor INR and prothrombin times. Hypotension with calcium channel blockers metabolized by CYP3A4 (eg, verapamil, amlodipine, diltiazem).
Diarrhea, vomiting, dyspepsia, nausea, abdominal pain, abnormal taste, headache, insomnia, rash, increased BUN; hepatotoxicity, QT prolongation, C. difficile associated diarrhea, hypersensitivity reactions.
XL, tabs (YES); susp (NO)
XL tabs, tabs—60; Biaxin XL-Pac (14 x 500mg XL tabs)—4; Susp—50mL, 100mL