Klaricid

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

- Disturbances of the gut such as diarrhoea, nausea, vomiting, indigestion, abdominal pain
- Sore mouth
- Tongue or tooth discolouration
- Oral thrush
- Headache
- Pain in the muscles or joints
- Disturbance of taste or smell
- Allergic skin reactions
- Dizziness
- Difficulty sleeping or bad dreams
- Pins and needles
- Confusion
- Reversible loss of hearing
- Low blood sugar (hypoglycaemia)
- Liver or kidney disorders
- Abnormal heart beats (arrhythmias)

The side effects listed above may not include all of the side effects reported by the drug's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

How can this medicine affect other medicines?

It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to ensure that the combination is safe.

Clarithromycin should not be taken by people who are taking any of the following medicines:

- cisapride
- pimozide
- terfenadine
- ergot derivatives, eg ergotamine, dihydroergotamine.

This is because clarithromycin can raise the blood levels of these medicines, resulting in an increased risk of serious side effects on the heart.

Clarithromycin may also increase the blood level of the following medicines:

- carbamazepine
- ciclosporin
- colchicine
- digoxin
- disopyramide
- eletriptan
- itraconazole
- midazolam
- phenytoin
- quinidine
- rifabutin (increased risk of uveitis)
- sirolimus
- tacrolimus
- theophylline
- tolterodine
- triazolam.

If the blood levels of these medicines are raised by clarithromycin it may lead to an increase in the effects of these medicines, but also a possible increased risk of their side effects. Combined use should therefore be well monitored.

Clarithromycin may also increase the blood levels and hence anti-blood-clotting effects of the anticoagulants nicoumalone and warfarin. As this may increase the risk of bleeding, people taking these combinations, particularly elderly people, may need more frequent monitoring of their blood clotting time (INR) so the dose of anticoagulant can be adjusted if necessary.

Clarithromycin may also increase the blood levels of cholesterol-lowering medicines called statins, eg simvastatin and lovastatin. This may increase the risk of side effects on the muscles (myopathy) from these medicines.

This medicine may decrease the absorption of zidovudine from the gut. If you are taking both these medicines the clarithromycin should be taken at least two hours before or after the zidovudine to avoid the interaction. Ask your pharmacist for advice.

Ritonavir may increase the blood level of clarithromycin. This is not normally a problem, but if you have kidney problems and are taking ritonavir your doctor may prescribe you a lower than normal dose of clarithromycin.

If you are taking a combined oral contraceptive pill there may be a very low risk that this antibiotic may make it less effective at preventing pregnancy. Although this has not been reported with clarithromycin, the personal and ethical consequences of an unwanted pregnancy can be very serious. For this reason the Family Planning Association recommends that women taking combined oral contraceptives should use an extra method of contraception (eg condoms) while taking a short course of broad-spectrum antibiotic, and for seven days after finishing the course. If the seven days run beyond the end of a pill packet, a new packet should be started without a break (in the case of ED pills the inactive tablets should be omitted).

Other medicines containing the same active ingredient

Clarosip

Klaricid XL

Clarithromycin tablets and suspension also available without a brand name, ie as the generic medicine.

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