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clarithromycin - Biaxin

General Information Clarithromycin (Biaxin) is an antibiotic that is used to treat and prevent certain infections.
Specifics Clarithromycin is a well-respected and very effective antibiotic.  It has a long track record of effectiveness and safety.

Clarithromycin works by inhibiting the production of protein in bacteria.  Clarithromycin is used for a variety of purposes including but not limited to the following:

1.  To treat serious infections due to bacteria such as pneumonia
2.  To treat a serious infection called DMAC ("disseminated Mycobacterium avium complex") which is found in the blood, bone marrow, liver, and/or other organs.
3.  To prevent DMAC.  This is probably its most frequent use.

Clarithromycin is such an excellent and safe drug there may be tendency for it to be overused.  If it is overused in individuals or overall in the community, bacterial infections may become resistant to its effects.  Therefore, it is important to take this drug only when advised by someone that knows what they are doing.

Dosing Clarithromycin may be given by pill or liquid at a variety of doses to treat infections: the usual range is 500 mg twice a day depending on the type of infection.  There is also a once-a-day pill.

If taken to prevent DMAC, the usual dose is 500 mg twice a day.

This refers to your willingness, ability, and actual performance in taking your medications.

For further information and tips on adherence, go to the Adherence section of this site.

It is very important to take every dose that is prescribed unless instructed by your healthcare provider.

Do not adjust the dose or frequency of clarithromycin without speaking to your healthcare provider first.

If you miss doses, the infection that is being treated may not get better or sometimes the infection can even get much worse by the germ developing resistance to clarithromycin or you may get DMAC if you are taking clarithromycin for prevention.

It is strongly recommended that you consider using weekly pill boxes and arrange all of your doses a week in advance.  Buy a small pill box so that you can carry a dose or two of your medicines with you in case you are away from home.

Possible Side Effects
The package insert for most drugs including clarithromycin is often overwhelming and scary with perhaps an overemphasis on side effects.  We have summarized the important and more common problems here.

Most people take clarithromycin without any or very many side effects.  

Many side effects get better with time.

Other possible side effects include bad taste in your mouth, hearing loss, stomach upset, diarrhea, nausea, liver problems, fever, or allergic rashes.

Allergic rashes can be very minor to very serious (rarely,) but all rashes should be reported.  If you have rash that steadily gets worse or you have a rash and fever, you need to inform your healthcare provider immediately.

This refers to the way that clarithromycin affects other medications and how other medications might affect clarithromycin.
There are several drugs that should not be used with clarithromycin at all: terfenadine, astemizole, cisapride, pimozide.

There are several other drugs which should be used cautiously with the knowledge of their possible interactions with clarithromycin:

antacids (take clarithromycin at least an hour before the antacid)
oral contraceptives (birth control pills)
digoxin (this drug is used for heart problems)
anticoagulant treatment with warfarin (Coumadin)
ritonavir (Norvir) (only if you have kidney problems)
quinidine and disopyramide (drugs used for heart rhythm problems)
ergotamine or dihydroergotamine  (drugs used to treat migraine headaches)
triazolam, midazolam, alprazolam (drugs used to treat anxiety)
lovastatin and simvastatin (drugs used to treat cholesterol problems)
sildenafil (Viagra) and other drugs used for erectile dysfunction
cyclosporine, carbamazepine, tacrolimus, alfentanil, disopyramide, rifabutin, quinidine, methylprednisolone, cilostazol, and bromocriptine.

Make sure that your healthcare provider is aware of all the medications you are taking so that important and possibly dangerous interactions are not overlooked.

Report to you healthcare provider or go to an Emergency Room if you have severe side effects, increasing side effects, shortness of breath, fever, jaundice (eyes and skin turn yellow,) nausea and vomiting (so that you cannot hold down your food and liquids) or rash.
You can download this handout in PDF format by clicking HERE.