Antibiotic Klacid is an original drug for the treatment of bacterial infections in adults and children. Available in tablets, powder and granules for preparing a solution. Sold by prescription, the average price starts from 450 rubles per course. Due to the high cost, the presence of contraindications, dissatisfaction with the quality or effect, adverse reactions that have arisen, and defects in pharmacy organizations, buyers are interested in the question of how to replace Klacid. The selection of an analogue is carried out by a doctor; before purchasing, you should read the instructions for use.
pharmachologic effect
The active substance clarithromycin belongs to the group of macrolides, semisynthetic antibiotics. It produces an antibacterial effect by suppressing bacterial protein synthesis. The consistency of the tablet is such that the active ingredient is released gradually as the drug passes through the gastrointestinal tract. Clarithromycin is active against isolated and standard bacterial cultures. A high effect is observed when using the drug for the treatment of Legionnaires' disease, pneumonia of mycoplasma etiology. Gram-negative bacteria are not sensitive to clarithromycin.
actively acts as an antibacterial agent against group A streptococci , pneumococcus , Staphylococcus aureus , microorganisms that cause Haemophilus influenzae , listeriosis , gonorrhea , pneumochlamydia , leprosy , chlamydia , erysipelas , sporotrichosis .
Those pathogens that do not demonstrate sensitivity to oxacillin and methicillin are also resistant to the effects of clarithromycin.
A positive effect of clarithromycin was also noted in relation to the following microorganisms (efficacy and safety were not confirmed in clinical trials): viridans streptococcus, peptococcus, group B, C, F, G streptococci; pathogens of avian pasteurellosis, whooping cough , human toxic infections, acne , borreliosis, syphilis , enterocolitis.
During the metabolism of clarithromycin in the body, active 14-hydroxyclarithromycin is released, which exhibits microbiological activity. Metabolism occurs in the human liver. If a person took the drug regularly, there was no increase in the activity of its influence.
Klacid or Augmentin
Augmentin is a substitute for Amoxiclav, with the same composition: it contains amoxicillin and clavulanic acid. Available in dispersible and soluble tablets, as well as suspension. Due to the frequent prescription of Augmentin by doctors, bacteria have developed resistance to the active substance of the drug. In these cases, the drug of choice is the original Klacid.
Pharmacokinetics and pharmacodynamics
The substance clarithromycin binds well to blood proteins. The highest concentration of the drug is determined within 6 hours. The larger the dose of the drug taken by the patient, the longer the period of time it is eliminated from the body. The amount of metabolite (14-hydroxyclarithromycin) does not increase in parallel with increasing doses of clarithromycin. The larger the dose of Klacid taken, the less 14-hydroxyclarithromycin is formed in the body.
The medicine is excreted from the body through the kidneys and intestines (40% and 30% of the dose, respectively). After oral administration, clarithromycin and its metabolite are distributed throughout the tissues and fluids of the body; tissues typically contain twice as much of the drug compared to blood serum.
No dosage adjustment is required for liver diseases. In case of kidney disease, the period of elimination of clarithromycin from the body increases. Also, the elimination period of the drug increases in older people.
Klacid gran. d/prig. susp. 125mg/5ml 100ml (70.7g)
A country
Italy
The country of production may vary depending on the batch of goods. Please check with the operator for detailed information when confirming your order.
Compound
Granules for preparing a suspension - 5 ml of the finished suspension: Active substances: clarithromycin - 125 mg; Excipients: carbomer (carbopol 974P) - 75 mg, povidone K90 - 17.5 mg, silicon dioxide - 5 mg, maltodextrin - 285.7 mg, sucrose - 2748.3 mg, titanium dioxide - 35.7 mg, xanthan gum - 3.8 mg, fruit flavoring - 35.7 mg, potassium sorbate - 20 mg, anhydrous citric acid - 4.2 mg, hypromellose phthalate - 152.1 mg, castor oil - 16.1 mg. 42.3 g - plastic bottles with a volume of 60 ml (1) complete with a dosing spoon or dosing syringe - cardboard packs. Description: Granules for the preparation of a suspension for oral administration in the form of a granular powder from white to light yellow in color, with a fruity aroma; When shaken with water, an opaque suspension of white to light yellow color is formed, with a fruity aroma.
Pharmacological properties
Pharmacodynamics: Clarithromycin is a semisynthetic antibiotic of the macrolide group and has an antibacterial effect by interacting with the 50S ribosomal subunit of sensitive bacteria and inhibiting protein synthesis. Clarithromycin has demonstrated high in vitro activity against standard and isolated bacterial cultures. Highly effective against many aerobic and anaerobic, gram-positive and gram-negative microorganisms. Clarithromycin is highly effective in vitro against Legionella pneumophila, Mycoplasma pneumoniae and Helicobacter (Campilobacter) pylori. Enterobacteriaceae and Pseudomonas, as well as other non-lactose-degrading gram-negative bacteria, are not sensitive to clarithromycin. Clarithromycin has been shown to have an antibacterial effect against the following pathogens: aerobic gram-positive microorganisms - Staphylococcus aureus, Streptococcus pneumoniae, Streptococcus pyogenes, Listeria monocytogenes; aerobic gram-negative microorganisms: Haemophilus influenzae, Haemophilus parainftuenzae, Moraxella catarrhalis, Legionella pneumophila, Neisseria gonorrhoeae; other microorganisms - Mycoplasma pneumoniae, Chlamydia pneumoniae (TWAR), Chlamydia trachomatis; mycobacteria - Mycobacterium leprae, Mycobacterium kansasii, Mycobacterium chelonae, Mycobacterium fortuitum; Mycobacterium avium complex (MAC) - a complex including: Mycobacterium avium, Mycobacterium intracellulare. The production of beta-lactamase does not affect the activity of clarithromycin. Most strains of staphylococci resistant to methicillin and oxacillin are also resistant to clarithromycin. Helicobacter pylori. The sensitivity of H. pylori to clarithromycin was studied on H. pylori isolates isolated from 104 patients before starting drug therapy. In 4 patients, strains of H. pylori were isolated that were resistant to clarithromycin, in 2, strains with intermediate resistance were isolated, and in the remaining 98 patients, H. pylori isolates were sensitive to clarithromycin. Clarithromycin has an effect in vitro and against most strains of the following microorganisms (however, the safety and effectiveness of the use of clarithromycin in clinical practice has not been confirmed by clinical studies and the practical significance remains unclear): aerobic gram-positive microorganisms - Streptococcus agalactiae, Streptococci (groups C, F, G), Viridans group streptococci; aerobic gram-negative microorganisms - Bordetella pertussis, Pasteurella multocida; anaerobic gram-positive microorganisms - Clostridium perfringens, Peptococcus niger, Propionibacterium acnes; anaerobic gram-negative microorganisms - Bacteroides melaninogenicus; spirochetes - Borrelia burgdorferi, Treponema pallidum; campylobacter - Campylobacter jejuni. The main metabolite of clarithromycin in the human body is the microbiologically active metabolite - 14-hydroxyclarithromycin (14-OH-clarithromycin). The microbiological activity of the metabolite is the same as that of the parent substance, or 1–2 times weaker against most microorganisms. The exception is H.influenzae, for which the effectiveness of the metabolite is 2 times higher. The parent substance and its major metabolite have either additive or synergistic effects against H. influenzae in vitro and in vivo, depending on the bacterial culture. Susceptibility studies Quantitative methods, which require measuring the diameter of the zone of growth inhibition of microorganisms, provide the most accurate estimates of the sensitivity of bacteria to antimicrobial agents. One recommended susceptibility testing procedure uses discs soaked in 15 μg of clarithromycin (Kirby-Bauer diffusion test); the test results are interpreted depending on the diameter of the zone of growth inhibition of the microorganism and the MIC value of clarithromycin. The MIC value is determined by diluting the medium or diffusion into agar. Laboratory tests give one of 3 results: resistant - the infection can be considered not amenable to treatment with this drug; moderately sensitive - the therapeutic effect is ambiguous, and possibly increasing the dosage may lead to sensitivity; sensitive - the infection can be considered treatable with clarithromycin. Pharmacokinetics: The drug is rapidly absorbed into the gastrointestinal tract. Absolute bioavailability is about 50%. With repeated doses of the drug, no accumulation was detected, and the nature of metabolism in the human body did not change. Eating immediately before taking the drug increased the bioavailability of the drug by an average of 25%. Clarithromycin can be taken before or with meals. In vitro In in vitro studies, the binding of clarithromycin to plasma proteins was 70% at concentrations from 0.45 to 4.5 μg/ml. At a concentration of 45 μg/ml, binding decreases to 41%, probably as a result of saturation of binding sites. This is observed only at concentrations many times higher than the therapeutic value. Healthy When clarithromycin was prescribed at a dose of 250 mg 2 times a day, the maximum Css of clarithromycin and 14-hydroxyclarithromycin in plasma were achieved after 2-3 days and were 1 and 0.6 μg/ml, respectively. T1/2 of the parent drug and its main metabolite were 3–4 and 5–6 hours, respectively. When clarithromycin was prescribed at a dose of 500 mg 2 times a day, the maximum Css of clarithromycin and 14-hydroxyclarithromycin in plasma were achieved after taking the 5th dose and amounted to on average 2.7–2.9 and 0.88–0.83 μg/ml, respectively. T1/2 of the parent drug and its main metabolite were 4.5–4.8 hours and 6.9–8.7 hours, respectively. At steady state, the level of 14-hydroxyclarithromycin does not increase in proportion to the doses of clarithromycin, and T1/2 of clarithromycin and its main metabolite increases with increasing dose. The nonlinear nature of the pharmacokinetics of clarithromycin is associated with a decrease in the formation of 14-OH- and N-demethylated metabolites when using higher doses, which indicates the nonlinearity of the metabolism of clarithromycin when taking high doses. About 37.9% are excreted in the urine after taking 250 mg and 46% after taking 1200 mg of clarithromycin, and through the intestines - about 40.2 and 29.1%, respectively. Clarithromycin and its 14-OH metabolite are well distributed into tissues and body fluids. After oral administration of clarithromycin, its content in the cerebrospinal fluid remains low (with normal BBB permeability of 1–2% of serum levels). The content in tissues is usually several times higher than the content in blood serum. Hepatic impairment: In patients with moderate to severe hepatic impairment but with preserved renal function, no clarithromycin dosage adjustment is required. Css in blood plasma and systemic clearance of clarithromycin do not differ between patients in this group and healthy patients. Css of 14-hydroxyclarithromycin in people with impaired liver function is lower than in healthy people. Impaired renal function If renal function is impaired, the minimum and maximum levels of clarithromycin in the blood plasma, T1/2, AUC of clarithromycin and 14-OH metabolite increase. The elimination constant and urinary excretion decrease. The degree of changes in these parameters depends on the degree of renal dysfunction. Elderly patients Elderly patients had higher levels of clarithromycin and its 14-OH metabolite in the blood and slower elimination than the younger group. It is believed that changes in pharmacokinetics in elderly patients are associated primarily with changes in creatinine clearance and renal function, and not with the age of the patients. Patients with mycobacterial infections Css of clarithromycin and 14-OH-clarithromycin in patients with HIV infection receiving clarithromycin in usual doses (500 mg 2 times daily) were similar to those in healthy people. However, when clarithromycin is used in higher doses, which may be required to treat mycobacterial infections, antibiotic concentrations may be significantly higher than usual. In patients with HIV infection taking clarithromycin at a dose of 1000 and 2000 mg/day in 2 divided doses, Css were usually 2–4 and 5–10 μg/ml, respectively. When using the drug in higher doses, a prolongation of T1/2 was observed compared with that in healthy people receiving clarithromycin in usual doses. The increase in plasma concentrations and T1/2 duration when clarithromycin is prescribed at higher doses is consistent with the known nonlinearity of the pharmacokinetics of the drug. Combination treatment with omeprazole Clarithromycin 500 mg 3 times a day in combination with omeprazole at a dose of 40 mg/day helps to increase T1/2 and AUC0-24 of omeprazole. In all patients receiving combination therapy, compared with those receiving omeprazole alone, there was an 89% increase in AUC0-24 and a 34% increase in T1/2 of omeprazole. For clarithromycin, Cmax, Cmin and AUC0-8 increased by 10, 27 and 15%, respectively, compared with data when clarithromycin alone was used without omeprazole. At steady state, clarithromycin concentrations in the gastric mucosa 6 hours after dosing in the group receiving the combination were 25 times higher than those in those receiving clarithromycin alone. Concentrations of clarithromycin in gastric tissue 6 hours after taking 2 drugs were 2 times higher than the data obtained in the group of patients receiving only clarithromycin.
Indications for use
Infectious and inflammatory diseases caused by microorganisms sensitive to clarithromycin: lower respiratory tract infections (such as bronchitis, pneumonia); upper respiratory tract infections (such as pharyngitis, sinusitis); infections of the skin and soft tissues (such as folliculitis, inflammation of the subcutaneous tissue, erysipelas); disseminated or localized mycobacterial infections caused by Mycobacterium avium and Mycobacterium intracellulare; localized infections caused by Mycobacterium chelonae, Mycobacterium fortuitum and Mycobacterium kansasii; acute otitis media.
Contraindications
hypersensitivity to clarithromycin, macrolides and other components of the drug;
simultaneous use of clarithromycin with the following drugs: astemizole, cisapride, pimozide, terfenadine (see section “Interaction with other drugs”); simultaneous use of clarithromycin with ergot alkaloids, for example, ergotamine, dihydroergotamine (see section “Interaction with other drugs”); simultaneous use of clarithromycin with midazolam for oral use (see section “Interaction with other drugs”); simultaneous use of clarithromycin with HMG-CoA reductase inhibitors (statins), which are largely metabolized by the CYP3A4 isoenzyme (lovastatin or simvastatin), due to an increased risk of myopathy, including rhabdomyolysis (see section “Interaction with other drugs”); simultaneous use of clarithromycin with colchicine (see section “Interaction with other drugs”); simultaneous use of clarithromycin with ticagrelor or ranolazine; history of prolongation of the QT interval (congenital or acquired registered prolongation of the QT interval) or ventricular arrhythmia, including ventricular tachycardia of the “pirouette” type (see sections “Special instructions” and “Interaction with other drugs”); hypokalemia (risk of QT interval prolongation); severe liver failure occurring simultaneously with renal failure; history of cholestatic jaundice/hepatitis that developed during the use of clarithromycin (see section “Special Instructions”); congenital fructose intolerance, sucrase-isomaltase deficiency, glucose-galactose malabsorption syndrome; porphyria; breastfeeding period With caution: moderate to severe renal failure; moderate to severe liver failure; patients with coronary artery disease (CHD), severe heart failure, hypomagnesemia, conduction disturbances or clinically significant bradycardia; diabetes mellitus (the drug contains sucrose). Use during pregnancy and children: the use of clarithromycin during pregnancy (especially in the first trimester) is possible only when there is no alternative therapy, and the potential benefit to the mother outweighs the potential risk to the fetus. If it is necessary to take it during lactation, breastfeeding should be stopped.
Mode of application
For oral administration. The prepared suspension can be taken regardless of food intake, including with milk. Preparation for use: gradually add water to the bottle to the mark and shake to obtain 60 ml or 100 ml of a suspension containing 125 mg of clarithromycin per 5 ml. The finished suspension can be stored for 14 days at room temperature (15 to 30 °C). Before each dose, the suspension should be shaken well. The recommended daily dose of clarithromycin suspension for non-mycobacterial infections in children is 7.5 mg/kg 2 times a day (maximum 500 mg 2 times a day). The usual duration of treatment is 5-10 days, depending on the pathogen and the severity of the condition. In children with disseminated or localized mycobacterial infections (M. Avium, M. intracellulare, M. chelonae, M. fortuitum, M. kansasii), the recommended daily dose of clarithromycin is 7.5-15 mg/kg 2 times a day and should not exceed the maximum dose is 500 mg 2 times a day. In children with CC less than 30 ml/min/1.73 m2, the dose of clarithromycin should be halved.
Side effect
Allergic reactions: rash; from the nervous system: headache, insomnia; from the skin: intense sweating; from the digestive system: diarrhea, vomiting, dyspepsia, nausea, abdominal pain; from the senses: dysgeusia; from the cardiovascular system: vasodilation; laboratory parameters: abnormal liver test.
Overdose
In case of overdose, the unabsorbed drug should be removed from the gastrointestinal tract (gastric lavage, taking activated charcoal, etc.) and symptomatic therapy should be carried out. Hemodialysis and peritoneal dialysis do not have a significant effect on the concentration of clarithromycin in serum, which is also typical for other macrolide drugs.
Interaction
Antiarrhythmic drugs (quinidine and disopyramide): ventricular tachycardia of the “pirouette” type may occur when clarithromycin is used together with quinidine or disopyramide. When clarithromycin is used together with oral hypoglycemic agents (for example, sulfonylureas) and/or insulin, severe hypoglycemia may occur. Indirect anticoagulants: when taking warfarin and clarithromycin together, bleeding and a marked increase in INR and prothrombin time are possible.
special instructions
It is possible to develop cross-resistance to clarithromycin and other macrolide antibiotics, as well as lincomycin and clindamycin. Prescription of clarithromycin to pregnant women should be carried out with a careful assessment of the risk-benefit ratio, especially during the first three months of pregnancy.
Dispensing conditions in pharmacies
On prescription
Indications for use
The use of the drug Klacid is indicated for the following diseases and conditions:
- infectious diseases of the lower respiratory tract: pneumonia , bronchitis , etc.;
- infectious diseases of the upper respiratory tract: sore throat , sinusitis , pharyngitis , etc.;
- infectious lesions of soft tissues, skin: folliculitis , erysipelas , etc.;
- mycobacterial infections caused by Mycobacterium intracellulare and Mycobacterium avium;
- infections caused by Mycobacterium fortuitum, Mycobacterium chelonae, Mycobacterium kansasii.
It is also practiced to take the drug to prevent infection caused by Mycobacterium avium complex (MAC). Prescribed to reduce the frequency of relapses of duodenal ulcers .
Klacid and Klacid SR
Klacid ®
and
Klacid ® SR
(lat.
Klacid ®
and
Klacid ® SR
) are antibiotics of the macrolide class.
The active ingredient is clarithromycin. In gastroenterology, Klacid ®
is known as one of the antibiotic drugs used as part of complex therapy for the eradication of
Helicobacter pylori
.
Dosage forms of Klacida
Klacid and Klacid SR are available in the following dosage forms:
- Klacid SR is a long-acting
yellow, oval, film-coated tablet containing 500 mg of clarithromycin (clarithromycin is released gradually during the passage of the tablet through the gastrointestinal tract). - Klacid are immediate-release
yellow, oval, film-coated tablets containing 250 mg of clarithromycin. - Klacid are
light yellow, oval, film-coated, immediate-release - Klacid is a powder for the preparation of a suspension for oral administration, white or almost white, granular, with a fruity aroma, 5 ml of the finished suspension contains 125 mg of clarithromycin (“125 mg/5 ml”).
- Klacid is a powder for the preparation of a suspension for oral administration, white or almost white granules with a fruity aroma, 5 ml of the finished suspension contains 250 mg of clarithromycin (“250 mg/5 ml”).
- Klacid - lyophilisate for the preparation of solution for infusion; white to almost white in color, with a faint aromatic odor; one vial contains 500 mg of clarithromycin.
Indications for use of Klacid SR extended release
Klacid SR and Klacid in the form of a lyophilisate for preparing a solution for infusion are used for the treatment of infectious and inflammatory diseases caused by microbes sensitive to the drug: the lower and upper respiratory tract and ENT organs (bronchitis, pneumonia, pharyngitis, sinusitis, etc.), skin and soft tissues, including folliculitis, inflammation of the subcutaneous tissue, erysipelas. Note. Klacid SR is not recommended for use as part of Helicobacter pylori eradication regimens.
Indications for use of Klacida suspension
Klacid in the form of a suspension is used to treat the infectious diseases listed above in the section “Indications for the use of Klacid SR prolonged action”, as well as mycobacterial infections, widespread or localized, caused by Mycobacterium avium
and
Mycobacterium intracellulare
and localized infections caused by
Mycobacterium chelonae, Mycobacterium fortuitum
and
Mycobacterium kansasii.
In addition, Klacid in the form of a suspension is used as part of Helicobacter pylori
and in the prevention of relapses of duodenal ulcers (only in combination with other drugs!).
Indications for use of Klacida immediate release
Klacid in immediate-release tablets is used to treat the infectious diseases listed above in the sections “Indications for the use of Klacid SR extended-release” and “Indications for the use of Klacid suspension,” as well as to prevent the spread of infection caused by the Mycobacterium avium
in HIV-infected patients containing T -helper lymphocytes no more than 100 per 1 mm3 and odontogenic infections.
Directions for use and dosage of Klacid tablets (immediate release)
Klacid tablets are taken orally, without connection with food intake.
Adults, unless the doctor prescribes otherwise, take one Klacid tablet containing 250 mg of clarithromycin, 2 times a day. In more severe cases, the dose is doubled. The duration of treatment is from 5 to 14 days. Patients with creatinine Cl less than 30 ml/min are prescribed one 250 mg tablet once a day, or for more severe infections - one 250 mg tablet 2 times a day for no more than 14 days.
For the treatment of mycobacterial infections, Klacid is taken based on a dose of 500 mg of clarithromycin 2 times a day. The duration of treatment is determined by the doctor
For common infections caused by Mycobacterium avium
, in patients with AIDS: treatment with Klacid (in combination with other antimicrobial drugs) continues as long as there is a positive effect.
Klacid for Helicobacter pylori
and prevention of relapses of peptic ulcer disease are taken only as part of a complex of drugs, the dose and order of administration depends on the eradication “scheme” used (see the article “Clarithromycin” or “Standards for the diagnosis and treatment of acid-dependent and Helicobacter pylori-associated diseases (the fourth Moscow Agreement)”) .
Professional medical publications regarding the use of Klacid in the eradication of Helicobacter pylori
- Maev I.V., Samsonov A.A., Andreev N.G., Kochetov S.A. Clarithromycin as the main element of eradication therapy for diseases associated with Helicobacter pylori infection // Gastroenterology. 2011. No. 1.
On the website gastroscan.ru in the literature catalog there is a section “Antibiotics used in the treatment of gastrointestinal diseases”, containing articles on the use of antimicrobial agents in the treatment of diseases of the digestive tract.
Procedure for use and dose of Klacid in the form of a suspension
The Klacid suspension is prepared by gradually adding water to the bottle with granules to the level of the mark, after which the bottle is shaken.
You should get 60 ml of a Klacid suspension containing 125 mg of clarithromycin in 5 ml, or 100 ml of a suspension containing 250 mg of clarithromycin in 5 ml. Klacida suspension is stored at room temperature for up to two weeks. The suspension is taken orally, with milk, with or without food. Before use, the bottle of Klacida suspension must be shaken well. Dosage of Klacida suspension in the treatment of non-mycobacterial infections in children
. The duration of treatment is 5–7 days, depending on the pathogen and the patient’s condition. A single dose of Klacid suspension is calculated based on 7.5 mg of clarithromycin per kg of patient weight. The calculated dose is taken twice a day. The maximum dose of Klacid is 500 mg of clarithromycin 2 times a day. In order to determine a single dose of the Klacid suspension, one can proceed from the following:
- for children weighing up to 8 kg - proceed from the above 7.5 mg of clarithromycin per kg of weight
- for children weighing 8 to 11 kg, take half a teaspoon (5 ml) of Klacida suspension containing 125 mg of clarithromycin per 5 ml (“125 mg/5 ml”) twice daily
- for children weighing from 12 to 19 kg - take a teaspoon of Klacid suspension “125 mg/5 ml” or half a teaspoon of Klacid suspension containing 250 mg of clarithromycin per 5 ml (“250 mg/5 ml”) twice a day
- for children weighing from 20 to 29 kg - take one and a half teaspoons of Klacid suspension “125 mg/5 ml” or 0.75 teaspoons of Klacid suspension “250 mg/5 ml” twice a day
- for children weighing from 30 to 40 kg - take 2 teaspoons of Klacida suspension “125 mg/5 ml” or one teaspoon of Klacida suspension “250 mg/5 ml” twice a day
The dose of Klacid suspension in children with mycobacterial infections
is calculated based on taking 15–30 mg of clarithromycin per kg of child weight per day in two divided doses. Take Klacid as long as the clinical effect remains.
When treating children with AIDS
The recommended dose is calculated based on 15–30 mg of clarithromycin per kg of child weight per day.
Procedure for use and dose of Klacid SR (long-acting)
Swallow Klacid SR tablets whole, without cutting, chewing, or crushing, one tablet once a day during meals. For severe infections, take two tablets once a day. The duration of treatment is from 5 to 14 days.
Use of Klacid during pregnancy, lactation and children
The use of Klacid in the first trimester of pregnancy is contraindicated. In the second and third trimesters of pregnancy, taking Klacid is possible if the expected benefit to the mother outweighs the potential risk to the fetus.
When treating a mother with Klacid, breastfeeding should be stopped.
Due to insufficient data on effectiveness and safety, it is not recommended to take Klacida for children under three years of age, and Klacida SR for children under 18 years of age.
Other medicines containing the active ingredient clarithromycin
Having (had) registration in Russia:
Bacticap, Biotericin, Zimbaktar, Kispar, Klabaks, Klabaks OD, Klarbakt, Clarithromycin-Verte, Clarithromycin-J, Clarithromycin Zentiva, Clarithromycin Protech, Clarithromycin Pfizer, Clarithromycin retard-OBL, Clarithromycin SR, Clarithromycin- Teva, Clarithromycin Ecositrin, Clarithromycin-OBL, Clarithrosin, Claricin, Claricite, Claromin, Klasine, Clerimed, Coater, Lecoclair, Mycetinum, Romiclar, Seydon-Sanovel, SR-Klaren, Fromilid and Fromilid Uno, Ecositrin.
A drug with a complex active ingredient omeprazole + tinidazole + clarithromycin - Pilobact, with an active ingredient omeprazole + amoxicillin + clarithromycin - Pilobact AM . Presented on the Ukrainian pharmaceutical market:
- Clarithromycin: Claritro Sandoz, Claritro Sandoz XL
- combination of clarithromycin + rabeprazole + ornizadol: Ornistat, etc.
Clarithromycin brands in different countries:
Crixan, Biaxin, Klaricid, Klabax, Klacid, Claripen, Clarem, Claridar, Fromilid, Clacid, Clacee, Vikrol, Infex, Clariwin.
general information
According to the pharmacological index, Klacid and Klacid SR belong to the group “macrolides and azalides”.
According to ATC, they belong to the group “J01 Antibacterial drugs for systemic use” and have the code J01FA09. Information about the medicinal properties of Klacid and Klacid SR, including: a list of microorganisms against which Klacid is active, Klacid in Helicobacter pylori
, antibiotic resistance
of Helicobacter pylori
to Klacid (clarithromycin), preservation of intestinal microflora during Klacid therapy, pharmacokinetics of clarithromycin, interaction of Klacid with other drugs, contraindications when taking Klacid - see the article “Clarithromycin”.
The manufacturer of Klacida and Klacida SR is Abbott Laboratories, USA, France, Italy.
All forms of Klacid have contraindications, side effects and application features; consultation with a specialist is necessary.
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Contraindications
You should not take an antibiotic in the following cases:
- with high sensitivity of the body to drugs from the macrolide group;
- with porphyria ;
- during pregnancy and lactation ;
- children under 3 years of age.
The drug is prescribed with caution in cases of kidney and liver dysfunction.
You cannot take clarithromycin and the following medications at the same time : terfenadine , cisapride , dihydroergotamine , pimozide , ergotamine , and stemizole .
Side effects
If Klacid is administered IV or taken orally, a number of side effects may occur. If such effects occur after intravenous administration or ingestion of tablets, you must inform your specialist.
The following manifestations are possible:
- the central nervous system: changes in taste, headaches .
- Digestive system: nausea , abdominal pain, diarrhea , vomiting , dyspepsia .
- Local reactions when injecting the solution: inflammatory processes at the injection site, phlebitis , pain during palpation.
- Laboratory indicators: increased activity of liver enzymes.
In addition to these side effects, there are possible side effects that occur less frequently:
- oral candidiasis;
- thrombocytopenia , leukopenia ;
- anaphylactic reactions;
- hypoglycemia;
- mental disorders, insomnia ;
- dizziness , convulsions ;
- myalgia;
- reversible hearing loss;
- ventricular tachycardia ;
- stomatitis , acute pancreatitis , glossitis ;
- liver dysfunction;
- hives , rash ;
- increased creatinine levels in the blood.
Instructions for use Klacida (Method and dosage)
Instructions for use of Klacid for children and adults include taking the drug orally, regardless of food intake.
Adult patients are advised to take 250 mg of clarithromycin twice a day. If severe diseases, mycobacterial infections are being treated, the dose can be increased to 500 mg twice a day. In most cases, treatment lasts from 5 to 14 days.
If Klacid suspension is prescribed for treatment, the instructions for use must be strictly followed. The suspension is prescribed for treatment for children; it can be taken regardless of food intake, and can be taken with milk. To prepare the suspension for use, you need to gradually add water to the bottle to the mark, then shake. 5 ml of 60 ml suspension contains 125 mg of clarithromycin; 5 ml of 100 ml suspension contains 250 mg of clarithromycin. The suspension can be stored for two weeks at room temperature.
Before giving the antibiotic Klacid to children, shake the suspension thoroughly. It is recommended to use a dose of 7.5 mg per 1 kg of body weight twice a day for children. The highest permissible dose is 500 mg twice a day. Therapy can last from 5 to 10 days.
Klacid or Sumamed
Sumamed is a substitute for Klacid based on azithromycin, available in suspension, capsules and tablets for children and adults. For convenient use, if it is necessary to dissolve in water or dissolve, if there are difficulties in swallowing, a new form has been created - dispersible tablets. Another advantage is that the price is up to 25% lower.
Sumamed belongs to the group of macrolides and has a bactericidal and bactericidal effect. Klacid is from the same group of antibiotics. The difference is in the active substance, pricing policy, course of use. Sumamed is better for children if there is no addiction and resistance to azithromycin.
Advantages: lower price, use in children 2 times a day for 5–7 days. The course of treatment in adults is 3–5 days.
Which is stronger – Klacid or Sumamed individually. Before prescribing, it is necessary to determine the causative agent of the disease and antibiotic resistance. Sumamed is not used to treat gastritis caused by Helicobacter pylori. When used, there is an increase in liver tests and a negative effect on the intestinal microflora. When using Klacid, allergic reactions and neurological symptoms may occur. The choice of drug should be made on the basis of the analysis performed.
Interaction
Astemizole , Pimozide , terfenadine , cisapride is strictly prohibited , since in this case the development of serious side effects is likely. In particular, the manifestation of cardiac arrhythmias, including ventricular fibrillation and ventricular tachycardia, is possible.
With the simultaneous use of clarithromycin and ergotamine or dihydroergotamine , acute poisoning with drugs of the ergotamine group is possible. In particular, limb ischemia, vascular spasm, etc. may occur. The simultaneous use of clarithromycin and ergot alkaloids is not allowed.
CYP3A inducers induce the metabolism of clarithromycin. As a result, the concentration of clarithromycin and its effectiveness decrease. If clarithromycin and Rifabutin are used simultaneously , the plasma concentration of Rifabutin increases and the concentration of clarithromycin decreases .
The drugs Nevirapine , Efavirenz , Rifabutin , Rifapentine can accelerate the metabolism of clarithromycin, thereby reducing its concentration in plasma and increasing the concentration of its metabolite - 14-OH-clarithromycin. As a result, therapeutic effectiveness may decrease.
A decrease in the concentration of clarithromycin is observed when taken together with etravirine .
It is necessary to adjust drug doses when taking clarithromycin and ritonavir .
With simultaneous treatment with Klacid and oral hypoglycemic drugs or insulin, severe hypoglycemia may occur. Glucose levels should be constantly monitored.
When taking an antibiotic simultaneously with Quinidine , Disopyramide , ventricular tachycardia is possible.
Clarithromycin should be taken with caution in those receiving medications that are substrates of the CYP3A isoenzyme, as well as in combination with statins.
Concomitant treatment with clarithromycin and Simvastatin .
It is important to monitor the patient's condition during co-treatment with arfarin and clarithromycin due to the likelihood of bleeding.
When taking clarithromycin and tadalafil , sildenafil , vardenafil , there is a need to reduce the dosage of the latter drugs.
Simultaneous treatment with antibiotics and Theophylline or Carbamazepine leads to an increase in the concentration of these drugs in the bloodstream.
When using clarithromycin and triazolam , an effect on the central nervous system is likely, resulting in drowsiness and confusion.
People who have impaired liver or kidney function should not take clarithromycin and colchicine
With simultaneous treatment with clarithromycin and Digoxin , the effect of the latter is enhanced. Constant monitoring of the level of digoxin in the blood serum is necessary.
There is a bidirectional effect of drugs when taking clarithromycin and atazanavir , as well as clarithromycin and Itraconazole , clarithromycin and saquinavir .
When treated simultaneously with an antibiotic and Amlodipine , Verapamil , Diltiazem , the likelihood of developing arterial hypotension increases.
Publications in the media
Clarithromycin (Klabax, Klatsid, Fromilid), granules for the preparation of an oral suspension, capsules, lyophilisate for the preparation of a solution for infusion, powder for the preparation of an oral suspension, film-coated tablets, film-coated tablets with extended release
Pharmaceutical group - macrolide antibiotic.
Pharmaceutical action. Semi-synthetic broad-spectrum macrolide antibiotic. Disturbs the protein synthesis of microorganisms (binds to the 50S subunit of the ribosomal membrane of the microbial cell). Acts on extra- and intracellularly located pathogens. Active against: Staphylococcus spp., Streptococcus agalactiae (Streptococcus pyogenes, Streptococcus viridans, Streptococcus pneumoniae), Haemophilus influenzae (Haemophilus parainfluenzae), Haemophilus ducreyi, Neisseria gonorrhoeae, Neisseria meningitidis, Listeria monocytogenes, Legionella pneumophila, Mycoplasma pneumonia e, Helicobacter pylori (Campylobacter ), Campylobacter jejuni, Chlamydia pneumoniae, Moraxella catarrhalis, Bordetella pertussis, Propionibacterium acne, Mycobacterium avium, Mycobacterium leprae, Mycobacterium cansasii, Mycobacterium marinom, Staphylococcus aureus, Ureaplasma urealyticum, Toxoplasma gondii, Corynebacterium spp., Borrelia burgdorferi, Pasteur ella multocida, some anaerobes (Eubacter spp., Peptococcus spp., Propionibacterium spp., Clostridium perfringens, Bacteroides melaninogenicus), less active against Mycobacterium tuberculosis.
Pharmacokinetics. Absorption is fast. Food slows absorption without significantly affecting bioavailability. The bioavailability of clarithromycin in suspension form is equivalent to or slightly higher than when taken in tablet form. Communication with plasma proteins is more than 90%. After a single dose, 2 Cmax peaks are recorded. The second peak is due to the ability of the drug to concentrate in the gallbladder, followed by gradual or rapid entry into the intestine and absorption. TCmax when taken orally 250 mg - 1-3 hours. After oral administration, 20% of the dose taken is quickly hydroxylated in the liver by cytochrome enzymes CYP3A4, CYP3A5 and CYP3A7 with the formation of the main metabolite - 14-hydroxyclarithromycin, which has pronounced antimicrobial activity against Haemophilus influenzae. It is an inhibitor of the isoenzymes CYP3A4, CYP3A5 and CYP3A7. With regular intake of 250 mg/day, Css of the unchanged drug and its main metabolite is 1 and 0.6 μg/ml, respectively; T1/2 - 3-4 and 5-6 hours, respectively. When the dose is increased to 500 mg/day, Css of the unchanged drug and its metabolite in plasma is 2.7-2.9 and 0.83-0.88 mcg/ml, respectively; T1/2 - 4.8-5 and 6.9-8.7 hours, respectively. At therapeutic concentrations it accumulates in the lungs, skin and soft tissues (concentrations there are 10 times higher than the level in blood serum). It is excreted by the kidneys and in feces (20-30% in unchanged form, the rest in the form of metabolites). With a single dose of 250 and 1200 mg, 37.9 and 46% are excreted by the kidneys, and 40.2 and 29.1% are excreted in the feces, respectively.
Indications. Lower respiratory tract infections (including bronchitis, pneumonia). Infections of the upper respiratory tract (including pharyngitis, sinusitis). Infections of the skin and soft tissues (including folliculitis, erysipelas). Mycobacterial infections caused by Mycobacterium avium and Mycobacterium intracellulare. Localized infections caused by Mycobacterium fortuitum and Mycobacterium kansasii. Prevention of the spread of infection caused by Mycobacterium avium complex (MAC infection) in HIV-infected patients with a CD4 lymphocyte count of no more than 100/μl. Eradication of Helicobacter pylori to reduce the frequency of relapses of duodenal ulcer. Odontogenic infections. For long-acting dosage forms: lower respiratory tract infections (including bronchitis, pneumonia), upper respiratory tract infections (including pharyngitis, sinusitis), skin and soft tissue infections (including folliculitis, erysipelas ).
Contraindications. Hypersensitivity, porphyria, pregnancy (first trimester), lactation, simultaneous use of cisapride, pimozide, terfenadine. Carefully. Renal and/or liver failure.
Dosing. Orally, adults and children over 12 years old - 250-500 mg 2 times a day. Duration of treatment is 6-14 days. In case of severe infections or in case of difficulty in oral administration, it is prescribed in the form of intravenous injections at a dose of 500 mg/day for 2-5 days, with further transfer to oral administration of 500 mg/day. The total duration of treatment is 10 days. When treating infections caused by Mycobacterium avium, 500 mg is prescribed orally 2 times a day. Duration of treatment is 6 months or more. Children are prescribed as a suspension at a dose of 7.5 mg/kg every 12 hours. The maximum daily dose is 500 mg. The duration of treatment is 7-10 days. In patients with chronic renal failure (creatinine clearance less than 30 ml/min or serum creatinine concentration more than 3.3 mg/100 ml) - 250 mg/day (once), for severe infections - 250 mg 2 times a day. The maximum duration of treatment for patients in this group is 14 days.
Side effect . From the nervous system: headache, dizziness, anxiety, fear, insomnia, nightmares; rarely - disorientation, hallucinations, psychosis, depersonalization, confusion. From the digestive system: nausea, vomiting, gastralgia, diarrhea, stomatitis, glossitis, increased activity of liver transaminases, cholestatic jaundice, rarely - pseudomembranous enterocolitis. From the senses: tinnitus, change in taste (dysgeusia); in isolated cases, hearing loss occurs after discontinuation of the drug. From the hematopoietic organs and hemostasis system: rarely - thrombocytopenia (unusual bleeding, hemorrhage). Allergic reactions: skin rash, itching, malignant exudative erythema (Stevens-Johnson syndrome), anaphylactoid reactions. Other: development of resistance of microorganisms.
Overdose. Symptoms: dysfunction of the gastrointestinal tract, headache, confusion. Treatment: gastric lavage, symptomatic therapy. Interaction. Simultaneous use with cisapride, pimozide, terfenadine is not allowed. When taken simultaneously, it increases the concentration in the blood of drugs metabolized in the liver with the help of cytochrome P450 enzymes - indirect anticoagulants, carbamazepine, theophylline, astemizole, cisapride, terfenadine (2-3 times), triazolam, midazolam, cyclosporine, disopyramide, phenytoin, rifabutin , lovastatin, digoxin, ergot alkaloids, etc. Reduces the absorption of zidovudine (an interval of at least 4 hours is required between the use of drugs). Cross-resistance may develop between clarithromycin, lincomycin and clindamycin.
Special instructions . In the presence of chronic liver diseases, it is necessary to regularly monitor serum enzymes. Prescribe with caution against the background of drugs metabolized by the liver (it is recommended to measure their concentration in the blood). In case of co-administration with warfarin or other indirect anticoagulants, it is necessary to monitor the prothrombin time.
special instructions
People with liver disease may experience changes in serum enzyme levels, for which tablets should be prescribed with caution.
It is prescribed with caution to people who are simultaneously taking other medications that are metabolized by the liver.
With prolonged treatment with antibiotics, the formation of colonies with a large number of insensitive fungi and bacteria is possible.
In case of chronic liver diseases, serum enzymes should be regularly monitored.
Pseudomembranous colitis may occur during antibiotic treatment. It is also possible to change the normal intestinal microflora.
The medicine should be prescribed with caution to people with severe heart failure, bradycardia, and hypomagnesemia. It is necessary to constantly monitor the ECG, determining the increase in the QT interval.
of myasthenia gravis may increase in people who take clarithromycin.
The powder for preparing the Klacid suspension contains sucrose, which should be taken into account by people suffering from diabetes .
When treating with clarithromycin, you need to carefully drive vehicles and perform activities that require high concentration.
Which is better – Klacid or Flemoxin solutab
Flemoxin is an imported analogue of Klacida suspension for children, available in the form of soluble tablets. Contains amoxicillin. Apply 2-3 times a day for 5-10 days. Prescribed for the treatment of gastritis and stomach ulcers caused by the bacterium Helicobacter pylori.
Klacid and Flemoxin solutab are antibacterial drugs that differ in composition, indications, and features of use. Which is better depends on your medical history. Both medications are prescription medications; the choice can be made together with a specialist.
Antibiotic Klacid is available in tablets, granules and powder for suspension. Soluble forms are used in childhood and are characterized by rapid action. The selection of cheaper analogues for children and adults should be carried out by a doctor, according to the results of an analysis of bacterial resistance.
Klacida's analogs
Level 4 ATC code matches:
Ecositrin
Azicine
Rovamycin
AzitRus
Safocid
Clarithromycin
Sumamed Forte
Klarbakt
Azithromycin
Azitro Sandoz
Sumamed
ZI-Factor
Azitral
Azimed
Azicide
Spiramycin-vero
Zitrolide
Ecomed
Macropen
Klacid SR
Analogues of Klacid are products that belong to the same group and have an active substance similar to Klacid. These are the medications:
- Klacid SR
- Clubax
- Fromilid
- Klarbakt
- Clerimed
- Clarexide
- Bacticap
- Binocular
- Claricite
- Clarithrosin
- Clarithromycin
- Claromine
You can replace the drug only after the doctor’s approval, since each of these drugs has certain features of use and side effects.
The price of analogues can be either higher or lower. The differences between Klacid and Klacid SR are that the latter drug is a long-acting drug, that is, the active substance is released more slowly.
Klabaks or Klacid
Klabax is an Indian substitute for Klacida based on clarithromycin. Available in one form - tablets containing the active substance 250 and 500 mg.
Klabax and Klacid are identical drugs with the same substance and indications and restrictions. The difference is that the analogue is cheaper, because it uses raw materials from another manufacturer, and has not been subjected to clinical trials to test the effectiveness and incidence of adverse reactions.
Klacid for children
Klacid for children can be used from the age of three. In most cases, children are prescribed Klacid suspension. Reviews for children indicate that this drug is quite effective. At the same time, the price of the suspension is quite high. The dosage for children is as follows: 7.5 mg per 1 kg of child’s weight twice a day. The highest daily dose is 500 mg.
Children over 12 years of age are prescribed 250 mg (tablets) twice a day. There is evidence that children tolerate Klacid more easily than other antibiotics. Therefore, the drug is often prescribed for sore throat , bronchitis , pneumonia , etc. However, we should not forget that side effects still occur.
Suprax or Klacid
Suprax is an analogue of modern cephalosporins based on cefixime. Prescribed for pharyngitis, tonsillitis and sinusitis, bronchitis, otitis media, uncomplicated forms of gonorrhea and urinary tract infections. In children's practice, it is used as prescribed by a doctor from 6 months, produced in syrup. For adults, it is sold in the form of oral or water-soluble tablets and capsules.
Suprax is used by adults once a day at the same time for 7–10 days. For children, the daily dose can be divided into two doses.
For sore throat caused by hemolytic streptococcus, it is better to choose a drug other than Suprax or Klacid 500 mg. What is more effective is individual in each therapeutic regimen; the result of treatment depends on the type of pathogen and sensitivity to antibiotics.
Reviews about Klacida
Reviews about Klacida are both positive and not too enthusiastic. Many patients note that the antibiotic is effective and significantly speeds up the healing process. But there are also stories that the drug provoked side effects, and as a result the doctor was forced to select a different antibiotic for treatment.
Parents who gave the drug to their children also leave different reviews of Klacid. No less important are the reviews of doctors, which indicate that experts consider this antibiotic to be effective and is often prescribed to both adults and children.
Klacida price, where to buy
You can buy this antibiotic at any pharmacy; its cost depends on the form and dosage.
The price of Klacid 250 mg tablets averages 650 rubles per pack of 10 tablets. The price of Klacid 500 mg is from 800 rubles per pack of 14 pcs. The price of granules for preparing Klacid suspension is on average 500 rubles.
- Online pharmacies in RussiaRussia
- Online pharmacies in KazakhstanKazakhstan
ZdravCity
- Klacid tablets p.p.o.
500 mg 14 pcs. Abbott S.r.L./ Ebbwy S.r.L. RUB 823 order - Klacid tablets p.p.o. 250 mg 10 pcs. Abbott S.r.L./ Ebbwy S.r.L.
RUR 669 order
Pharmacy Dialogue
- Klacid (tab. 250 mg No. 10) EbbVi
RUR 631 order
- Klacid tablets 500 mg No. 14EbbVi
RUB 812 order
- Klacid gran. d/prig. susp. 125mg/5ml 100ml (70.7g) EbbVie
610 rub. order
- Klacid (portable d/p. suspension 250 mg/5 ml 49.5 g) EbbVi
RUB 874 order
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Klacid or Clarithromycin - which is better?
Klacid is an original, imported drug based on clarithromycin. Available in tablets of two dosages - Klacid 250 mg and 500 mg, suspension for children. It has a wide spectrum of action and is used for diseases of the ENT organs, respiratory system, skin and soft tissues.
Clarithromycin is a cheaper analogue of Klacid. It is produced under the patent of a foreign pharmaceutical company, but has not been clinically studied; the bioavailability of the drug and the frequency of adverse reactions have not been determined. Other additional substances and technology, raw materials from another manufacturer are used. The Russian substitute is available only in tablets of 250 and 500 mg; there is also an Israeli analogue.
The Israeli drug Clarithromycin-Teva is the closest in effectiveness, the price of which is higher than the Russian one.
