Monitoring of vestibular and auditory function should be carried out during and after treatment. The primary route of metabolism for tolterodine is via the 2D6 isoform of cytochrome P450 (CYP2D6). Therefore blood glucose levels should be monitored during concomitant administration of clarithromycin and disopyramide.Concomitant use of oral clarithromycin and cyclosporin or tacrolimus have resulted in more than a 2-fold increase of the CThe use of clarithromycin in patients receiving warfarin may result in potentiation of the effects of warfarin. In children the following steady-state parameters were observed after the ninth dose in a dose regimen of 7,5 mg/kg twice daily on average for clarithromycin: CAfter administration of 250 mg clarithromycin twice daily the microbiologically active 14-hydroxy metabolite attains peak plasma concentrations of 0,6 µg/ml. No embryotoxicity or teratogenicity was generally noted in rat studies. Uncommon:Alanine aminotransferase increased, aspartate aminotransferase increasedNot known: Hepatic failure*, jaundice hepatocellularNot known: Stevens-Johnson syndrome* and toxic epidermal necrolysis*, drug rash with eosinophilia and systemic symptoms (DRESS), acne, acute generalised exanthematous pustulosis (AGEP)Not known: International normalized ratio increasedIn some of the reports of rhabdomyolysis, clarithromycin was administered concomitantly with statins, fibrates, colchicine or allopurinol (see section 4.3 and 4.4).There have been post-marketing reports of drug interactions and central nervous system (CNS) effects (e.g. Slightly higher incidences of abnormal values were noted for patients who received 4000mg daily for all parameters except White Blood Cell.Reporting suspected adverse reactions after authorisation of the medicinal product is important. somnolence and confusion) with the concomitant use of clarithromycin and triazolam. Dosage adjustments may be considered, and when possible, serum concentrations of drugs primarily metabolized by CYP3A should be monitored closely in patients concurrently receiving clarithromycin.The following drugs or drug classes are known or suspected to be metabolized by the same CYP3A isozyme: alprazolam, astemizole, carbamazepine, cilostazol, cisapride, cyclosporine, disopyramide, ergot alkaloids, lovastatin, methylprednisolone, midazolam, omeprazole, oral anticoagulants (e.g. Within each frequency grouping, adverse reactions are presented in order of decreasing seriousness when the seriousness could be assessed. Some patients have shown clinical signs consistent with digoxin toxicity, including potentially fatal arrhythmias. 7.5 mg/kg once a day, and the duration of treatment should not exceed 14 days.The duration of therapy with Clarithromycin 125 mg/5 ml suspension depends on the clinical condition of the patient. The risk for humans is unknown. This interaction is unlikely when clarithromycin is administered via intravenous infusion.There have been spontaneous or published reports of interactions of CYP3A inhibitors, including clarithromycin with drugs not thought to be metabolized by CYP3A (e.g. At a massive dose of 400mg/kg/day some dogs and monkeys developed corneal opacities and/or oedema. For details on any other sources used for this leaflet, please contact us through our website, We take great care to make sure that the information in this leaflet is correct and up-to-date. Reviewed by: May 2017.The primary source for the information in this leaflet is the British National Formulary for Children. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. It will only take 2 minutes of your time and we would really appreciate it :) Monitoring the patient for increased CNS pharmacological effects is suggested.Caution is advised regarding concomitant administration of clarithromycin with other ototoxic drugs, especially with aminoglycosides. Deaths have been reported in some such patients (see section 4.5). • Patients with coronary artery disease, severe cardiac insufficiency, conduction disturbances or clinically relevant bradycardia. It is highly potent against a wide variety of aerobic and anaerobic gram-positive and gram-negative organisms. Caution should be exercised when prescribing clarithromycin with statins. Careful monitoring of glucose is recommended.Clarithromycin (500 mg every 8 hours) was given in combination with omeprazole (40 mg daily) to healthy adult subjects. In the event of severe acute hypersensitivity reactions, such as anaphylaxis, severe cutaneous adverse reactions (SCAR) (e.g. Some patients may have had pre-existing hepatic disease or may have been taking other hepatotoxic medicinal products.