Drug Information for CLARITHROMYCIN (KAISER FOUNDATION HOSPITALS): PRECAUTIONS

General

Prescribing clarithromycin in the absence of a proven or strongly suspected bacterial infection or aprophylactic indication is unlikely to provide benefit to the patient and increases the risk of thedevelopment of drug-resistant bacteria.

Clarithromycin is principally excreted via the liver and kidney. Clarithromycin may be administeredwithout dosage adjustment to patients with hepatic impairment and normal renal function. However, inthe presence of severe renal impairment with or without coexisting hepatic impairment, decreaseddosage or prolonged dosing intervals may be appropriate.

Clarithromycin in combination with ranitidine bismuth citrate therapy is not recommended in patientswith creatinine clearance less than 25 mL/min. (See DOSAGE AND ADMINISTRATION.)

Clarithromycin in combination with ranitidine bismuth citrate should not be used in patients with ahistory of acute porphyria.

Exacerbation of symptoms of myasthenia gravis and new onset of symptoms of myasthenicsyndrome has been reported in patients receiving clarithromycin therapy.

For information about precautions of other drugs indicated in combination with clarithromycin, refer tothe PRECAUTIONS section of their package inserts.