Following is information on contraindications to the use of clarithromycin in general, pregnancy & amp; Breastfeeding and children. Please note that the contraindications may vary depending on the dosage form of a drug (eg tablet, syringe, ointment).
When should Clarithromycin not be used?
In case of hypersensitivity to clarithromycin and other macrolide antibiotics, the active substance should not be used under any circumstances. In case of allergic reactions to lincomycin or clindamycin, clarithromycin should only be used after consulting the doctor.
When blood potassium levels are low (hypokalaemia), treatment with clarithromycin is not permitted as life-threatening cardiac arrhythmias may otherwise occur. Patients whose cardiac arrest recovery is slowed or disturbed (such as long-QT syndrome), or who use the drugs pimozide or carbamazepine should not use clarithromycin because of the risk of potential heart arrhythmias.
In general, the use of clarithromycin in cardiovascular disorders, such as coronary artery stenosis (angina pectoris), severe heart failure (heart failure), low magnesium levels or low heart rate (less than 50 beats per minute) is only allowed after consultation with a doctor. !!!
Clarithromycin may be used with appropriate medical control in renal impairment with a creatinine clearance less than 30 milliliters per minute. However, this does not apply to combination therapy with omeprazole and metronidazole to combat the bacterium Helicobacter pylori.
Clarithromycin should only be used in hepatic impairment after consulting the doctor. The combination therapy for the treatment of gastric and duodenal ulcers is not permitted.
In patients suffering from myasthenia gravis, an autoimmune disease of skeletal muscle, clarithromycin may be used after careful consideration of the benefit and risk by the attending physician. However, the active ingredient, like all macrolide antibiotics, can aggravate this condition.
What should you watch out for during pregnancy and lactation?
Since the safety of the use of clarithromycin for pregnancy has not yet been demonstrated, the drug should only be used during this time after consultation with the doctor.
It is known that the active substance passes into breast milk and thus into the baby. This can lead to a disturbance of the intestinal flora, which can cause diarrhea or intestinal inflammation by infestation with mushrooms. In addition, there is the potential for sensitization of the infant, that is, later contact with clarithromycin may cause the body to be allergic to the drug. For these reasons, the antibiotic should also be used during breastfeeding only after consultation with the attending physician.
What should be considered in children?
Children under the age of twelve should preferably be treated with clarithromycin in tablet form.
Warnings and Precautions
- In the event of dysfunction of the liver and kidneys, the physician should monitor the treatment with the drug with particular care and adjust the dosage if necessary.
- Prolonged and repeated treatment with the drug increases the risk of developing resistant bacteria.
- If severe diarrhea occurs during or immediately after treatment with the drug, the doctor should be consulted.
- Patients with cardiac dysfunction must be carefully monitored by the doctor during treatment.
- Treatment with the drug may cause a myasthenia gravis to flare up or worsen.
- Because the drug interacts with many others, the doctor must tailor the therapy to the concomitant medications.
- If combined with a calcium channel blocker, the doctor should prescribe azithromycin instead of the drug.
Sometimes medications release allergic reactions.
If you notice any signs of allergic reaction, tell your doctor or pharmacist immediately.