Clarithromycin side effects

What side effects can clarithromycin have?

Below you will find the most important information about possible known side effects of clarithromycin.
These side effects do not occur, but you can. Because every person reacts differently to medication. Please also note that the type and frequency of side effects may vary depending on the drug formulation (eg tablet, syringe, ointment).

Common side effects:
abnormal taste, odor disturbance, tongue discoloration (all transient), gastrointestinal discomfort (stomach depression, nausea and vomiting, abdominal pain, flatulence), fungal infection of the mouth, headache, increased blood urea value, blood nitrogen value increase.

Uncommon side effects:
hearing disorders (ear noises, transient hearing loss),
hypersensitivity reactions (drug fever, skin rash, itching, hives, facial swelling such as angioedema, joint swelling, allergic shock), seizures (epilepsy), liver dysfunction, hepatitis, gall bladder , Jaundice.

Rare side effects:
Tooth discoloration, tongue inflammation, oral mucositis, fungal infections in the mouth, mental disorders (drowsiness, dizziness, confusion, disorientation, anxiety, insomnia, nightmares, hallucinations, psychosis), headache, liver dysfunction, upper abdominal discomfort, liver enzyme increase (transaminases ), Increase in bilirubin

Very rare side effects:
abnormal sensations (tingling, burning, paresthesia), convulsions, pancreatitis, allergic shock, fever, jaundice, liver failure, cardiac arrhythmia, deafness (mostly in patients with severe liver or kidney dysfunction), severe skin reactions (Stevens-Johnson syndrome), platelet deficiency (thrombocytopenia), white blood cell (leukopenia) deficiency

Side effects without frequency:
kidney inflammation, renal dysfunction, kidney failure, biliary congestion, joint pain, muscle pain, anticoagulation, skin tissue destruction, serum creatinine elevation, serum urea elevation

Special features:
The long-term and repeated use of the antibiotic may in very rare cases cause colon colonization with insensitive (resistant) bacteria or fungi. These can lead to intestinal inflammation with diarrhea (pseudomembranous colitis).

When clarithromycin is used as an infusion, pain and inflammation at the infusion site or venous wall irritation may rarely occur.

What interactions does clarithromycin show?

Please note that the interactions may vary depending on the drug formulation of a drug (eg tablet, syringe, ointment).

Clarithromycin is inhibited by other macrolide antibiotics, but also by lincomycin, clindamycin and chloramphenicol in its activity. In addition, it should be noted that bacteria that are no longer responsive to these antibiotics are often also insensitive to clarithromycin (resistant).

Non-hydrogenated ergot alkaloids such as ergotamine or dihydroergotamine in combination with clarithromycin increase the risk of excessive blood vessel narrowing. This can lead to under-supply of organs with oxygen and thus to tissue damage.

In the case of the following substances, in combination with clarithromycin, their concentration in the blood and thus their potency increases, which may lead to specific side effects: lovastatin, theophylline, carbamazepine, valproic acid, methylprednisolone, triazolam, midazolam, alfentanil, felodipine and anticoagulants of the type coumarin.

Concomitant use of the immunologic agent cyclosporine with clarithromycin increases the risk of renal damage. The combination of the antibiotic with terfenadine, astemizole or digoxin can cause life-threatening cardiac arrhythmias (Long QT Syndrome).

In combination with omeprazole or ritonavir, clarithromycin is potentiated in its action.

On the other hand, the following substances reduce the effects of clarithromycin: disopyramide, phenytoin, rifabutin, tacrolimus, alprazolam, cilostozol, sildenafil, vinblastine and quinidine.

Mineral antacids (acid-binding agents) can severely curtail the efficacy of clarithromycin so that a time gap of two to three hours should be kept between receipts. The efficacy of zidovudine is also compromised by concomitant use of clarithromycin. Here should be a time interval of about four hours between taking both drugs.

Concomitant use of clarithromycin with oral hypoglycaemic agents or insulin may in rare cases lead to a decrease in blood sugar (hypoglycaemia).

Clarithromycin may increase the effects of calcium channel blockers (against high blood pressure), especially in elderly patients, leading to life-threatening blood pressure drops. In combination, the doctor should therefore resort to azithromycin.

Potential Clarithromycin side effects may include: