In the article, we consider the instructions for “Clarbact”.
It is a drug with pronounced antibacterial, bacteriostatic, bactericidal properties. The specified medication refers to antimicrobial drugs of systemic effects and is included in the group of antibiotics of macrolides and azalides.
Pharmacological forms
The manufacturer "Clarbact" is available in tablet form. The tablets of the drug are white (almost white), capsule-shaped, coated, are on one side at risk for separation. On a cross-section, the tablet also has a white (almost white) color. A dosage unit may have a dosage of 250, 500 mg. Instructions for “Clarbact” are available in each pack.
The medicine is packaged in 4, 10 pieces in blisters, which are then additionally placed in a pack of cardboard.
Structure
According to the instructions for Clarbact, clarithromycin is the main component of the drug. Also, the preparation contains such additional substances as magnesium stearate, stearic acid, colloidal silicon dioxide, sodium starch glycolate, purified talc, polyvinylpyrrolidone, corn starch, gelatinized starch, microcrystalline cellulose.
The tablet shell is made from peppermint powder, lemon flavoring, polyethylene glycol 6000, methylene chloride, purified talc, hydroxypropyl methylcellulose, titanium dioxide, isopropanol.
In accordance with the instructions, “Clarbact”, by its pharmacological effect, refers to bactericidal antimicrobial medicines.
Pharmacodynamics, pharmacokinetics
It is an antibiotic drug belonging to the macrolide group, and is a semi-synthetic derivative of erythromycin.
The drug retains its stability in an acidic environment, is capable of exerting an antibacterial effect by inhibiting protein synthesis and interacting with 50S ribosomal substances. The bacteriostatic effect, bactericidal effect is characteristic of the drug.
As indicated by the instructions for use, Clarbact is active against a wide range of gram-positive, gram-negative anaerobes and aerobes. The most famous microorganisms having sensitivity to the medication:
- anaerobic microorganisms: some strains of propionobacteria, peptostreptococci, peptococci, clostridia, bacteriods;
- mycobacteria, chlamydia;
- mycoplasmas and ureaplasmas;
- various strains of mycobacteria;
- gram-negative aerobes: helicobacter, legionella, bordetella, neiseria, moraxella;
- gram-positive aerobes: listeria, streptococcus, staphylococcus.
With oral administration of Clarbact, clarithromycin is rapidly adsorbed by the tissues of the digestive tract, the maximum concentration of a substance in the blood plasma is noted after 2 hours, while the level of bioavailability reaches 68% (regardless of meals). After adsorption, the active component penetrates into many tissues except the central nervous system. About 80% of the active component binds to plasma proteins, clarithromycin is metabolized in the tissues of the liver, resulting in the formation of 14-hydroxyclarithromycin, a metabolite with similar antimicrobial properties, but several orders of magnitude less. About 36% of the taken substance is eliminated together with urine, about 52% - together with feces. The average half-elimination time of 250 mg (single dose) is 3-4 hours, the half-elimination of 500 mg is 5-6 hours.
Indications for use
According to the instructions, “Clarbact” is indicated for use in the treatment of bacterial infections provoked by sensitive pathogens:
- mycobacteriosis: atypical mycobacteriosis is subject to combination therapy with the parallel use of ethambutanol, rifabutin;
- ulcerative lesions of the duodenum 12, stomach (Helicobacter pylori eradication);
- chlamydia
- otitis media;
- skin pathologies, soft tissue lesions (wound infection, impetigo, furunculosis, folliculitis);
- infectious pathologies of the lower parts of the respiratory system, for example, pneumonia (typical, atypical), bronchitis (including during periods of exacerbation);
- infectious lesions of the upper respiratory system, for example, sinusitis, tonsillitis, pharyngitis, laryngitis.
Contraindications
Instructions for use with Clarbact indicate that the main contraindications to the use of the drug are such conditions (pathological, physiological) as:
- lactation period;
- the use of ergot alkaloids, pimosin, terfenadine, astemizole, cesapride;
- porphyria;
- impaired liver and kidney function;
- increased susceptibility to the substances in the composition of “klarbakta” ​​- erythromycin, other antibiotics of the macrolide group.
Caution should be exercised when prescribing Clarbact to patients undergoing drug therapy who are metabolized in the liver tissue.
Negative impact
According to the instructions and reviews for “Clarbact”, therapy with clarithromycin-based drugs can cause a variety of negative manifestations from the following organ systems.
- Allergic answers: pseudo-allergy reactions, Stevens-Johnson syndrome, rash, itching.
- Genitourinary tract: renal failure, interstitial nephritis, increased serum creatinine concentration.
- Hemostasis, hematopoiesis, CVS: blinking, ventricular flutter, paroxysmal ventricular tachycardia, ventricular arrhythmia, lengthening on the cardiogram of the QT interval, leukopenia, thrombocytopenia.
- Gastrointestinal tract: hepatitis, liver failure, pseudomembranous enterocolitis, increased activity of transient type liver transaminases, cholestatic jaundice, glossitis, stomatitis, functional gastrointestinal disorders (gastralgia, diarrhea, discomfort, vomiting, nausea).
- Sense organs, NS: hearing loss, paresthesia, psychosis, confusion, depersonalization, hallucinations, disorientation, taste change, tinnitus, nightmares, fear, anxiety, insomnia, headache, dizziness.
Use of medication
The tablets are intended for oral administration.
When treating adult patients, it is indicated to use 250 mg of the medicine twice a day, that is, only 500 mg. The instructions for Clarbact confirm this. If necessary, it is allowed to double the prescribed dosage. The standard duration of therapy is 6-14 days.
When prescribing to pediatric patients, it is indicated to use 7.5 mg of the drug per kilogram of body weight, with a maximum of no more than 500 mg per day. The standard duration of a therapeutic course is 7-10 days.
Overdose with this drug
With the development of intoxication, the patient has confusion, headache, dyspeptic manifestations.
Clarbactom intoxication therapy involves immediate gastric lavage and symptomatic therapy. Peritoneal dialysis and hemodialysis do not significantly reduce serum clarithromycin.
Drug Interactions with Other Medicines
The simultaneous use of Clarbact tablets with medications metabolized in the liver in the presence of isoenzymes of cytochrome P450 (ergot alkaloids, lovastatin, digoxin, phenytoin, rifabutin, disopyramide, cyclosporine, triazolamate, midazolamine, carbamazepine, nepamazole, carbamazepine, nepamazole, carbamazepine, nepamazole, carbamazepine, nepamazole, carbamazepine, nepamazole, carbamazepine, nepamazole blood concentration.
With parallel use with terfenadine, astemizole, pimozide, cisapride, their concentration significantly increases, resulting in a prolongation of the QT interval, the occurrence of ventricular flutter, ventricular fibrillation, ventricular paroxysmal tachycardia, ventricular fibrillation. Such a combination of medicines is considered prohibited.
When combined with HMG-CoA reductase inhibitors (simvastatin, lovastatin), acute forms of skeletal muscle necrosis develop.
The parallel use of digoxin provokes an increase in its concentration. To avoid the development of digitalis intoxication allows constant monitoring of the content of digoxin in the blood serum.
The simultaneous use of Clarbact with triazolam leads to a decrease in its clearance, as a result of which an increase in its pharmacological effect in the form of drowsiness, confusion is not ruled out.
In combination with ergot alkaloids, “Clarbact” provokes acute ergotamine intoxication, manifested by impaired sensitivity, severe peripheral vasospasm.
With simultaneous administration with zinavudine, its stationary concentration in the blood plasma decreases. Therefore, a four-hour interval should be maintained between doses of the drug.
Combination with ritonavir leads to an increase in the concentration of clarithromycin.
Special instructions for the use of this medicine
If the patient has a severe form of renal failure, and the creatinine clearance drops below 30 ml / min, experts recommend taking clarithromycin in the form of tablets with a quick release of the active component. In this case, the average dose should be halved, and therapy should be carried out no more than 14 days.
Repeated or prolonged use of Clarbact and other antibiotic drugs can lead to the development of superinfection, cross-resistance between drugs.
Keep in mind that prolonged diarrhea may be a symptom of pseudomembranous colitis. In such cases, you should immediately stop using the medicine.
“Clarbact” can cause the development of side symptoms from the central nervous system (confusion, disorientation, dizziness). Therefore, during the course of the therapeutic course, it is recommended to carefully carry out potentially dangerous work, including driving a car, with complex mechanisms.
The use of "Clarbact" in the lactation period, during pregnancy
It is important to note that there were no qualitatively controlled and adequate studies on the possibility of using the medication during pregnancy, however, the drug can be prescribed to patients in this category:
- If the therapeutic effect is expected to exceed the potential harm to the fetus.
- If alternative therapy is not possible.
Analogs of Clarbact
If necessary, “Clarbact” can be replaced by “Clubax”, “Zimbaktar”, “Kispar”, “Binoklar”, “Arvitsin”, “Ecocitrin”, “Azitsin”, “Rovamitsin”, “Azitrus”, “Safotsid”, “Clarithromycin” ”,“ Sumamed Forte ”,“ Azithromycin ”,“ Azitro Sandoz ”,“ Sumamed ”,“ Zi-Factor ”,“ Azitral ”,“ Azimed ”,“ Azicide ”,“ Spiramycin ”,“ Zitrolide ”,“ Ekomed ”, “Macropen”, “Klacid SR”, “Klacid”, “Ecositrin”.
It is important to understand that all of these Clarbact analogs have their own contraindications and can cause side symptoms. In this regard, it is necessary to coordinate with the doctor the possibility of replacing the drug.
Clarbact has analogues that have a different composition, but operate in a similar way. We can distinguish: "Roxithromycin"; Spiramycin "Azithromycin." These antibacterial substances also belong to the class of macrolides. They can penetrate deep into the cell to fight the most severe infections. If a person can not choose "Clarbact" in tablets or "Clarithromycin", then you need to make a decision based on the doctor's prescription. Indiscriminate use of antibacterial agents leads to tolerance (resistance). One way or another, it develops when taking any drug. Wrong human actions can accelerate its development. You need to be careful when taking any antibiotic. Analogs should be used in accordance with the instructions or recommendations of the doctor.
The cost of Clarbact
The average packaging cost of the drug depends on the number of tablets in it, the dosage of the active component. So, about 245 rubles will cost 10 tablets with a dosage of 500 mg. The instructions for use with Clarbact do not contain this information.
Reviews
Patients leave reviews about Clarbact mostly positive, they talk about it as an effective antibiotic drug that has established itself well. Often there are also negative responses, which is primarily associated with the occurrence of undesirable consequences. Many report that during drug therapy they had headaches, abdominal pain, dysbiosis, and a change in taste. Doctors, in turn, point out the drug as effective and advise strictly adhering to the recommendations in order to minimize the likelihood of developing side effects.
It is better to familiarize yourself with the reviews on the use of Clarbact in advance.