克拉霉素

克拉霉素is a处方类药物used to treat a wide variety of细菌在fections. Thismedication也可以使用在combination with反对-溃疡治疗某些类型的药物stomach溃疡s. It may also be used to prevent certain bacterial infections. Clarithromycin is known as amacrolideantibiotic。它通过停止增长来起作用bacteria。

克拉霉素is available under the following different brand names:Biaxin，，，，and Biaxin XL.

剂量of Clarithromycin：

Adult andpediatricdosages:

口服suspension

• 125mg/5毫升
• 250毫克/5毫升

Tablet

• 250毫克
• 500 mg

Tablet, extended-release (adult dosage only, safety and efficacy not established in children)

• 500 mg

剂量考虑 - 应如下给出：

AcuteExacerbationofChronic Bronchitis

Adults:

• 每12小时口服250-500毫克7-14天
• Extended-release: 1,000 mg orally once daily for 7 days

小儿：

• 15 mg/kg/day orally divided every 12 hours for 10 days

急性上颌Sinusitis

Adult Dosage:

• 每12小时口服500毫克14天
• Extended-release: 1,000 mg orally once daily for 14 days

小儿剂量：

• 15 mg/kg/day orally divided every 12 hours for 10 days

分枝杆菌Infection

Adult Dosage:

• 500 mg orally every 12 hours for 7-14 days
• 与抗菌药物一起使用rifampin和埃托尔布尔醇

小儿剂量：

预防and treatment

• 7.5 mg/kg orally divided every 12 hours; individual dose not to exceed 500 mg
• 20个月以下的儿童：克拉霉素的安全mycobacterium avium complexnot studied

消化性溃疡Disease

Adult Dosage:

• 500 mg orally every 8-12 hours for 10-14 days
• 作为2或3级药物组合的一部分regimen和bismuth subsalicylate，，，，amoxicillin，H2receptorantagonist，或质子泵抑制剂

Pharyngitis，，，，Tonsillitis

• 250毫克orally every 12 hours for 10 days

Streptococcal Pharyngitis

小儿剂量：

• 7 mg/kg orally every 12 hours for 10 days; individual dose not to exceed 500 mg

Community-AcquiredPneumonia

Adult Dosage:

• 250毫克orally every 12 hours for 7-14 days
• Extended-release: 1,000 mg orally once daily for 7 days

小儿剂量：

• 15 mg/kg/day orally divided every 12 hours for 10 days

百日咳（（off-label)

Adult dosage:

• 每天两次口服500毫克7天

小儿剂量：

• Infants under 1 month: safety and efficacy not established
• Infants 1-6 months: 7.5 mg/kg/dose orally every 12 hours for 7 days
• 在6个月内的婴儿：7.5 mg/kg/剂量每12小时，持续7天

Skin/皮肤SutureInfection

Adult Dosage:

• 250毫克orally for every 12 hours for 7-14 days

小儿剂量：

• 15 mg/kg/day orally divided every 12 hours for 10 days

Endocarditis

Adult Dosage:

预防

• 500 mg orally 30-60 minutes before surgical procedure

小儿剂量：

预防

• 15 mg/kg orally 30-60 minutes before the surgical procedure; individual dose not to exceed 500 mg

Dosing Modifications

• 肾脏impairment (肌酐clearance under 30 ml/min): reduce normal dosage by 50%
• In combination with atazanavir: creatinine clearance 30-60 ml/min decrease dose by 50%; creatinine clearance under 30 ml/min, decrease dose by 75%

Dosing Considerations

Susceptible organisms:

• 放线杆菌actinomycetemcomitans,放线菌israelii, Actinomyces naeslundii, Actinomyces odontolyticus, Afipia felis, Arachnia propionica, Bartonella henselae, Bartonella quintana, Chlamydia pneumoniae (TWAR agent), Bordetella pertussis, Borrelia recurrentis, Calymmatobacterium granulomatis, Campylobacter jejuni, Chlamydia spp, Haemophilus ducreyi, Haemophilus influenzae, Helicobacter pylori, Legionella pneumophila, Mycobacterium avium complex (MAC), Mycobacterium chelonae, Mycobacterium fortuitum, Mycobacterium genavense, Mycobacterium gordonae, Mycobacterium kansasii, Mycobacterium leprae, Mycobacterium marinum, Mycobacterium scrofulaceum, Mycobacterium simiae, Mycobacterium szulgai, Mycobacterium ulcerans, Mycobacterium xenopi, Mycoplasma pneumoniae, Moraxella (Branhamella) catarrhalis, Staphylococcus aureus, Streptococcus (group C, G), Streptococcus agalactiae (group B), Streptococcus bovis (group D), Streptococcus intermedius group (Streptococcus anginosus, Streptococcus intermedius, Streptococcus constellatus), Streptococcus pneumoniae (penicillin sensitive; minimal inhibitory concentration [MIC] under 0.1 mcg/mL), Streptococcus pyogenes (group A), viridans streptococci, Ureaplasma urealyticum
• 幽门螺杆菌（（和兰索拉唑and amoxicillin)
• First-line：A felis, B henselae, B quintana, B pertussis, C jejuni, C pneumoniae, H ducreyi, H pylori, Legionella spp, Mycobacterium avium complex (MAC), M chelonae, M fortuitum, M genavense, M gordonae, M marinum, M scrofulaceum, M simiae, M xenopi; no unanimity on others (H influenzae)

Common Side effects of Clarithromycin include:

• gastrointestinal（（gi）effects, general
• 不正常taste
• diarrhea
• nausea
• vomiting
• 高架血urea nitrogen（（BUN）
• abdominal pain
• 皮疹
• 在digestion
• 胃灼热
• headache
• longer time for血凝块
• 严重过敏反应（（anaphylaxis）
• loss of appetite
• 焦虑
• Clostridium difficilecolitis（（fever，，，，diarrhea,abdominalcramps)
• dizziness
• difficulty呼吸
• 高架liver功能测试
• 肿胀tongue
• 幻觉
• liver功能障碍
• 在flammationof the liver (hepatitis）
• low blood sugar（（hypoglycemia）
• 在creasedalkaline phosphatase（（ALP) levels in the blood
• 在creasedaspartate aminotransferase（（AST）levels in the blood
• 在creasedbilirubinlevels in the blood
• 在creased血清肌酐levels in the blood
• yellowing of skin and eyes (jaundice）
• 血液中白细胞量减少（白细胞减少）
• manic行为
• neuromuscular阻塞
• decreased white blood cells to fight infection (neutropenia）
• 胰腺炎
• psychosis
• heartrhythm disorder (QT prolongation)
• seizures
• Stevens-Johnson syndrome（（流感-like symptoms, followed by a blistering rash)
• low levels ofplatelets（（thrombocytopenia）
• gas (flatulence）

克拉霉素报道的克拉霉素的销售后副作用包括：

• 血and淋巴系统disorders: low levels of platelets (thrombocytopenia), decreased white blood cells to fight infection (agranulocytosis）
• 心脏疾病：快速和不规则的心跳（扭转点），快速心律（心室tachycardia），异常快速心律（心室心律不齐）
• earandlabyrinth疾病：旋转sensation（（眩晕），ringing in the ears（（tinnitus），deafnesswas reported chiefly in elderly women and was usually reversible
• gastrointestinal disorders: pancreatitis acute, tongue discoloration,齿变色，打bur
• 肝胆disorders: severe allergic reaction (anaphylactic reaction)
• immune systemdisorders: severe allergic reaction, rapid swelling (血管性水肿）
• 在fections and infestations: colitis due to recent use of antibiotics (假膜结肠炎），细菌在fection of the skin (cellulitis），感染，阴道感染
• 调查：缓慢血液凝结时间（prothrombin timeprolonged),白细胞计数decreased,在ternational normalized ratio增加;不正常urinecolor has been reported, associated with liver (hepatic）failure
• metabolismandnutritiondisorders: low血sugarhas been reported in patients taking oralhypoglycemicagents or在sulin
• 肌肉骨骼和connective tissue疾病：疾病muscletissue（（myopathy），肌肉组织的破坏（rhabdomyolysis）was reported and in some of the reports, clarithromycin was administrated concomitantly withstatins，，，，fibrates,秋水仙碱or别嘌醇，，，，muscle痉挛，，，，impaired脖子屈曲（（nuchalrigidity)
• nervous system disorders: convulsions, inability to taste (ageusia），不正常感觉of smell（（parosmia），丢失感觉ofsmell（（厌食），numbness and tingling, tremors, sleepiness, loss of consciousness,非自愿movement (运动障碍）
• 精神病障碍：精神病，混乱状态，人格化，depression，，，，disorientation, manic behavior,幻觉，，，，不正常行为，，，，不正常dreams
• 肾脏和urinarydisorders: inflammation in thekidney（（nephritis在terstitial），肾脏（肾）失败
• skin and皮下tissue disorders: Steven-Johnsonsyndrome（（流感-like symptoms, followed by a blistering rash),皮肤病学disorder (toxicepidermalnecrolysis or TEN), drug rash with嗜酸性粒细胞andsystemicsymptoms (DRESS),Henoch-Schonlein purpura（小血管的炎症），acne，爆发（爆发）（dermatitis大胆）， 过多的sweating，，，，flat, red area with small颠簸（（maculo-papular皮疹）
• vascular疾病：流血（hemorrhage）
• 其他:报告of colchicinetoxicity，有些导致death，，，，和concomitant use of clarithromycin and colchicine, especially in the elderly, some of which occurred in patients with kidney (renal) insufficiency,asthma，，，，nosebleed,血clot在the lung (pulmonary embolism）

本文档不包含所有可能的副作用，可能还会发生其他副作用。与您的联系physicianfor additional information about side effects.

如果你的doctorhas directed you to use this medication, your doctor or药剂师可能已经意识到任何可能的药物相互作用，并可能正在为您监视您。在与医生检查之前，请勿开始，停止或更换任何药物的剂量，healthcare provider, or pharmacist first.

• 克拉霉素has severe interactions with at least 25 different drugs.
• 克拉霉素has serious interactions with at least 215 different drugs.
• 克拉霉素has moderate interactions with at least 238 different drugs.
• 克拉霉素hasminor在teractions with at least 98 different drugs.

This information does not contain all possible interactions or adverse effects. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions, concerns, or for more information about this medicine.

Warnings

• Discontinue clarithromycin immediately if signs and symptoms of hepatitis occur (loss of appetite, jaundice, dark urine,pruritus，或招标abdomen）
• This medication contains clarithromycin. Do not take Biaxin or Biaxin XL if you are allergic to clarithromycin or any ingredients contained in this drug
• 如果服用过量，请获得医疗帮助或联系Poison Control Center立即地

禁忌症

• Documented hypersensitivity
• 与pimozide, cisapride, ergotamine, and dihydroergotamine
• 胆汁淤积性黄疸或与以前使用克拉霉素相关的肝功能障碍的史
• 与肾脏（肾脏）或肝（肝）患者的秋水仙碱共同给药
• 与由CYP3A4广泛代谢的HMG-COA还原酶抑制剂（他汀类药物）共同给药（汀类药物）（lovastatin，，，，simvastatin），due to the increased risk of muscle disease (myopathy), including destruction of muscle tissue (rhabdomyolysis)

Effects of Drug Abuse

• No information available

Short-Term Effects

• See "What Are Side Effects Associated with Using Clarithromycin?"

Long-Term Effects

• See "What Are Side Effects Associated with Using Clarithromycin?"

Cautions

• Severe kidney (renal) impairment
• 不得冷藏口服溶液
• 不使用pregnancy，，，，except when there is no alternativetherapy;通知patient关于潜在危害胎儿if pregnancy occurs while in therapy
• Use for endocarditis prophylaxis is appropriate only for high-risk patients, per American HeartAssociation（（AHA) guidelines
• Associated with heart rhythm disorder (QT interval prolongation) and infrequent cases of arrhythmias, including torsade de pointes; avoid using with ongoing proarrhythmic conditions (uncorrected low blood levels ofpotassium或低血液的水平magnesium），临床意义慢heart rate;请勿与IA类（奎尼丁，普racainamide）或III类（Dofetilide，dofetilide，amiodarone，，，，sotalol）antiarrhythmics
• Elderly patients may be more susceptible to drug-associated hear rate disorder (QT prolongation)
• 在患者中谨慎冠状动脉疾病;postmarketing trials suggest increased risk ofcardiovascularmortality
• Discontinue immediately if severe hypersensitivity reactions occur (severe allergic reaction (anaphylaxis), Stevens-Johnson syndrome, TEN, drug reaction with eosinophilia and systemic symptoms [DRESS] syndrome, Henoch-Schonleinpurpura）
• Clostridiumdifficile associated diarrhea reported with use of nearly all抗菌代理，包括克拉霉素
• May cause kidney在jurywhen administered concomitantly withcalcium channel blockersmetabolized by CYP3A4
• 不要与ranitidine/bismuth citrate with history of acuteporphyria或如果肌酐清除25 ml/min
• 与quetiapinemay result in quetiapine related toxicities includingneurolepticmalignant综合征，心律障碍（QT延长），嗜睡，站立时头晕，意识状态改变
• Exacerbation of重症肌无力or new发作报告的症状
• Hepatic dysfunction
• 肝脏增加enzyme据报道，有或没有黄疸的活性和肝细胞或胆汁淤积性肝炎。这可能很严重，通常是可逆的
• 在某些情况下,身受outc肝衰竭ome has been reported, generally in association with serious underlying diseases or concomitant medications
• Discontinue clarithromycin immediately if signs and symptoms of hepatitis occur (厌食，，，，jaundice, dark urine, pruritus, or tender abdomen)

怀孕和哺乳

• 如果利益超过风险，请在怀孕期间使用克拉霉素，请谨慎使用。动物研究showrisk and human studies are not available, or neither animal nor human studies were done
• 克拉霉素is excreted inbreast milk;use with caution ifbreastfeeding。Consult your doctor