Clarithromycin

C. diff Risk

Medium

Oral Bioavailability

Moderate

Approximate Cost

Spectrum Of Activity

Dosing

500 mg PO BID

General Information

Drug Monitoring

Monitor QTc in patients with increased risk

Adverse Effects

  • Neutropenia

  •  GI upset

  •  Prolongation of QTc interval

  •  Drug interactions

Major Interactions

  •  CYP450 interactions ++

  •  Other QTc prolonging agents

  •  Recommend review of pt medications due to high frequency of significant interactions

  •  Statins - increased rhabdo

  •  CCBs - hypotension, AKI

  • Colchicine - increased bone marrow toxicity

  •  Increased tacrolimus levels

  •  Increased phenytoin levels

  • Increased INR with warfarin

Additional Information

Very high tissue penetration and concentration intracellularly means in vivo activity may not be predicted by in vitro testing.

May exacerbate muscle weakness in persons with myasthenia gravis. Avoid Use.

Pharmacology

Antimicrobial class: Macrolide

Pregnancy category: C