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CLARITHROMYCIN SHOULD NOT BE USED IN PREGNANT WOMEN EXCEPT IN CLINICAL CIRCUMSTANCES WHERE NO ALTERNATIVE THERAPY IS APPROPRIATE. IF PREGNANCY OCCURS WHILE TAKING THIS DRUG, THE PATIENT SHOULD BE APPRISED OF THE POTENTIAL HAZARD TO THE FETUS. CLARITHROMYCIN HAS DEMONSTRATED ADVERSE EFFECTS OF PREGNANCY OUTCOME AND/OR EMBRYO-FETAL DEVELOPMENT IN MONKEYS, RATS, MICE, AND RABBITS AT DOSES THAT PRODUCED PLASMA LEVELS 2 TO 17 TIMES THE SERUM LEVELS ACHIEVED IN HUMANS TREATED AT THE MAXIMUM RECOMMENDED HUMAN DOSES (see PRECAUTIONS - Pregnancy).



Hepatic disorder, including increased liver enzymes, as well as hepatocellular and/or cholestatic hepatitis, with or without jaundice, has been stated with clarithromycin. This hepatic disorder could be severe and also is often relatively easy to fix. In some circumstances, hepatic failing with deadly result has actually been reported and also generally has actually been connected with serious concomitant treatments and/or hidden conditions. Signs of liver disease could consist of anorexia, jaundice, dark urine, pruritus, or tender abdomen. Terminate clarithromycin instantly if indications as well as signs of liver disease take place.



Clarithromycin has actually been connected with prolongation of the QT interval and also seldom situations of arrhythmia. Cases of torsades de pointes have actually been spontaneously reported during postmarketing security in patients obtaining clarithromycin. Fatalities have been reported. Clarithromycin ought to be stayed clear of in clients with recurring proarrhythmic conditions such as uncorrected hypokalemia or hypomagnesemia, medically considerable bradycardia (view CONTRAINDICATIONS) and also in individuals receiving Class IA (quinidine, procainamide) or Class III (dofetilide, amiodarone, sotalol) antiarrhythmic brokers. Senior people could be a lot more prone to drug-associated results on the QT interval.



Serious damaging reactions have actually been reported in patients taking clarithromycin concomitantly with CYP3A4 substrates. These include colchicine poisoning with colchicine; rhabdomyolysis with simvastatin, lovastatin, as well as atorvastatin; as well as hypotension with calcium network blockers metabolized by CYP3A4 (e. g. verapamil, amlodipine, diltiazem) (see CONTRAINDICATIONS as well as PRECAUTIONS - Drug Interactions). Clarithromycin needs to be made use of with care when carried out simultaneously with medicines that induce the cytochrome CYP3A4 enzyme (view PRECAUTIONS - Drug Interactions).