In the article, we consider the instructions for use with Clubax.
It is a semi-synthetic antibiotic that is active against a wide range of microorganisms, including intracellular obligate macrolides. It is obtained by modifying natural erythromycin by attaching a methoxy group to the sixth position of the lactone macrocyclic ring.
The benefits of this antibiotic
The main advantages compared to natural erythromycin:
- increased acid stability (the stomach becomes one hundred times more resistant to an acidic environment);
- an extensive list of antimicrobial activity;
- reduced cytotoxicity;
- improved pharmacokinetic properties;
- reduced minimally inhibitory concentrations;
- the absence of a cross-allergy drug with beta-lactam drugs.
Functioning mechanism
According to the instructions, “Klabaks” has a greater bacteriostatic effect, increasing the concentration produces a bactericidal effect. This drug is one of the few that exhibits antimicrobial activity against mycoplasmas. This bacterial group does not have a cell wall - this is the preferred target for many conventional antibiotics. The mechanism of its action is based on the inhibition of protein synthesis of prokaryotes. Due to binding to the 50S subunit of ribosomes, translation is disturbed, mutant peptides are collected, and the wrong amino acids are attached.
As indicated by the instructions for Klabaks tablets, the drug is active in relation to:
- facultative gram-positive anaerobes - Corynebacterium, Streptococcaceae, Staphylococcaceae, Listeriaceae;
- optional gram-negative anaerobes - Legionellacea, Neisseriaceae, Pasteurellaceae, strict anaerobes - Mycoplasmataceae;
- Chlamydiaceae, Spirochaetaceae, gram-negative microaerophiles - Campylobacteraceae, Helicobacteraceae;
- gram-positive aerobes - Alcaligenaceae;
- gram-positive anaerobes - Propionibacteriaceae;
- Toxoplasma gondii - parasitic protists.
Pharmacokinetics
When ingested, clarithromycin is perfectly absorbed from the digestive tract. Absorption is slowed by food intake, however, this does not affect the bioavailability of the active ingredient.
Clarithromycin enters the biological tissues and body fluids of the patient, reaching a concentration there ten times higher compared to plasma.
About 20% of the active substance is immediately metabolized with the appearance of the main metabolite of 14-hydrochlorarithromycin.
If the dosage is 250 milligrams, the elimination half-life is about 3-4 hours, and from 5 to 7 hours at a dosage of 500. The instruction for Clubax reports that it is excreted unchanged in the urine and in the form of metabolites.
Below you will find information about the drug with a dosage of 500 mg.
When is it used?
In accordance with the instruction "Clubax" is used in the treatment of infectious and inflammatory diseases caused by sensitivity to the active substance of pathogens of the following type:
- infections of the upper respiratory tract, as well as ENT organs (acute sinusitis, otitis media, tonsillopharyngitis);
- infections of the lower respiratory tract (community-acquired atypical and bacterial pneumonia, chronic exacerbated bronchitis, acute bronchitis);
- odontogenic infections;
- soft tissue and skin infections;
- mycobacterial infections (M.leprae, M.avium complex, M.marinum, M.kansasii) and their prevention in patients with AIDS;
- peptic ulcer of the stomach or duodenum with eradication of Helicobacter pylori (only as part of a combination treatment).
Contraindications
The instruction to "Clubax" contains information about contraindications. So, the drug is not prescribed in the following cases:
- if there is a history of a lengthening of the QT period, ventricular arrhythmia, or ventricular tachycardia of the pirouette type;
- severe liver failure, which occurs along with kidney failure;
- hypokalemia (the likelihood of a prolonged QT period);
- a history of hepatitis or cholestatic jaundice that developed with the use of clarithromycin;
- first trimester of pregnancy;
- porphyria;
- breastfeeding period (lactation);
- concomitant use of clarithromycin with terfenadine, pimozide, cisapride and astemizole; with ergot alkaloids, for example, dihydroergotamine, ergotamine; with midazoles for internal use;
- with statins (inhibitors of HMG-CoA reductase), largely metabolized by the CYP3A4 isoenzyme (simvastatin, lovastatin), with colchicine; with ranolazine or ticagrelor;
- excessive sensitivity to the active substance and other macrolides.
Drug dosage
According to the instructions to the Clubax, the dosage of the drug is individual. Children after 12 years and adults take a single dosage in an amount of from 0.25 to 1 gram, the frequency of admission is twice a day.
For patients under the age of twelve, the dosage per day is from 7.5 to 15 mg / kg per day in two doses.
Clarithromycin in children should be taken in the appropriate form of medication intended for this category of patients.
The duration of treatment is determined by the indications:
- in patients with impaired renal activity (the degree of serum creatinine over 3.3 mg per dL, CC below 30 ml per minute), the dosage is halved or the period between doses of the drug is doubled.
The maximum dose for adults during the day is two grams, for children - one gram. That is, you can drink either 4 or 2 tablets of 500 mg per day.
Instructions for use with Clubax are very detailed.
Side effects
Most often, side effects are manifested from the digestive tract, with a feeling of nausea, inflammation of the tongue, vomiting, diarrhea and abdominal pain. There is information about the occurrence of acute processes of severe and moderate intestinal inflammation, hearing loss during the treatment course.
Defects in the activity of the nervous system: unreasonable attacks of fear, insomnia, confused consciousness, excessive sweating, taste sensations may decrease; hallucinations, headaches, anxiety, and nightmares at night.
In isolated cases, signs of paresthesia are recorded - there is a tingling sensation in the limbs and numbness. An exceptional case is the occurrence of a condition of severe kidney failure with a fatal outcome.
There can be a different level of severity of an allergic reaction: from urticaria to the appearance of anaphylactic shock, in rare cases, the appearance of exudative malignant erythema.
In isolated cases, tachycardia and arrhythmia of the heartbeat are observed from the side of the heart and vascular system.
Infectious secondary diseases, such as thrush, can very rarely develop. The instruction for Klabaks 500 mg does not end there.
Treatment and special instructions to it
Caution is required to take the drug in patients with severe or moderate renal insufficiency; severe and moderate liver failure, with severe heart failure, coronary heart disease, hypomagnesemia and bradycardia of a pronounced type (below 50 beats per minute); along with benzodiazepines, for example, with Midazole, Triazole and Alprazole for intravenous administration; along with other ototoxic agents, in particular with aminoglycosides; along with drugs metabolized by SUR3A isoenzymes (including Carbamazepine, Vinblastine, Cilostazol, Tacrolimus, Cyclosporin, Sildenafil, Disopyramide, Rifabutin, Methylprednisolone, Hini Omeprazole, indirect anticoagulants; along with SUR3A4 inducers (including St. John's wort, Carbamazepine, Rifampicin, Phenobarbital, Phenytoin); along with statins, whose metabolism is not determined by SUR3A isoenzyme (including Fluvate; with slow calcium channel blockers metabolized by 34 isoenzymes (in including Diltiazem, Amlodipine, Verapamil); along with class 1A antiarrhythmic drugs (Procainamide, Quinidine) and III (Sotalol, Amiodarone and Dofetilide).
In the macrolide group, cross-resistance is observed between antibiotics.
Antibiotic therapy changes the normal intestinal flora, and therefore superinfection due to resistant microorganisms may develop.
It must be borne in mind that pseudomembranous colitis can cause persistent severe diarrhea.
The prothrombin time should be monitored periodically in patients if they receive clarithromycin along with Warfarin and other oral anticoagulants.
So it is said in the instructions for use with Clubax 500 mg.
Reviews about Clubax
Reviews about the drug are not always positive. This situation is due to the fact that he has many side effects. Negative reviews come from patients with individual macrolide intolerance.
Most people report digestive tract disorders with the complete exclusion of serious symptoms. Although there are a lot of side effects, the drug completely eliminates the cause of the disease. "Klabaks" can be used both independently and have a synergistic effect in anti-Helicobacter pylori complex treatment for ulcers that affect the duodenum.
It is very important to say that the drug should be taken under scrupulous medical supervision and in compliance with all the requirements of the instructions. It is necessary to comply with all the recommendations of a specialist and not to interrupt treatment ahead of schedule. If symptomatic improvement in general is required, 3-4 days are enough, however, to completely eliminate the pathogen, it takes longer to be treated.
We reviewed the drug "Clubax" instructions for use and reviews.