Maclar 500mg IV Injection

✔️ Dosage & Administration

For Adults:

• Chronic bronchitis (Acute bacterial exacerbation): 250 mg – 500 mg every 12 hours for 7–14 days.
• Sinusitis: 500 mg every 12 hours for 14 days.
• Community-acquired pneumonia: 250 mg every 12 hours for 7–14 days.
• Pharyngitis/Tonsillitis: 250 mg every 12 hours for 10 days.
• Skin infections: 250 mg every 12 hours for 7–14 days.
• MAC treatment & prevention: 500 mg every 12 hours (duration depends on the risk of infection).

For H. pylori Infection (Combination Therapy in Adults):

• Triple Therapy (Clarithromycin/Lansoprazole/Amoxicillin):
  • 500 mg Clarithromycin, 30 mg Lansoprazole, and 1 g Amoxicillin every 12 hours for 10–14 days.
• Triple Therapy (Clarithromycin/Omeprazole/Amoxicillin):
  • 500 mg Clarithromycin, 20 mg Omeprazole, and 1 g Amoxicillin every 12 hours for 10–14 days.
  • Patients with an active ulcer may need an additional 14–18 days of Omeprazole 20 mg once daily.
• Dual Therapy (Clarithromycin/Omeprazole):
  • 500 mg Clarithromycin every 8 hours + 40 mg Omeprazole once daily for 14 days, followed by Omeprazole 20 mg once daily for 14 additional days.

For Children:

• General infections: 15 mg/kg/day, divided every 12 hours for 10 days.
• MAC treatment & prevention: 7.5 mg/kg every 12 hours, up to 500 mg per dose.

For Patients with Renal or Hepatic Impairment:

• No dose adjustment is required for hepatic impairment if renal function is normal.
• Severe renal impairment may require dose reduction or extended dosing intervals.

Use only under the supervision of a registered doctor.

✔️ Overdose Effects

Symptoms of overdose:

• Severe gastrointestinal distress (nausea, vomiting, diarrhea).
• Mental status changes (paranoia, confusion, hallucinations).
• Electrolyte imbalances (low potassium – hypokalemia, low oxygen levels – hypoxemia).

Management:

• Immediate elimination of unabsorbed drug (gastric lavage, activated charcoal).
• Supportive care (fluid replacement, symptom management).
• Dialysis is not effective in removing Clarithromycin.

✔️ Maclar is generally well tolerated, but some patients may experience:

• Gastrointestinal issues: Nausea, vomiting, diarrhea, abdominal pain.
• Oral issues: Stomatitis (mouth inflammation), glossitis (tongue inflammation).
• Neurological effects: Headache, dizziness, insomnia, hallucinations, anxiety.
• Skin reactions: Allergic reactions, rash, urticaria (hives), anaphylaxis (rare).
• Taste changes: Altered taste perception.

✔️ Drug Interactions – What to Avoid?

Maclar should NOT be taken with:

• Cholesterol-lowering drugs: Lovastatin, Simvastatin (HMG-CoA reductase inhibitors).
• Gastrointestinal drugs: Cisapride (prokinetic agent).
• Ergot alkaloids: Ergotamine, Dihydroergotamine.
• Antipsychotics: Pimozide, Quetiapine.
• Anti-gout medications: Colchicine.
• Heart medications (Antiarrhythmics): Disopyramide, Quinidine, Dofetilide, Amiodarone, Sotalol, Procainamide.

✔️ Contraindications – Who Should Avoid Maclar?

Maclar is contraindicated in patients with:

• Allergy to macrolide antibiotics (Clarithromycin, Erythromycin, or related drugs).
• History of liver dysfunction (cholestatic jaundice or hepatic impairment due to Clarithromycin).

✔️ Pregnancy & Lactation – Is It Safe?

• Pregnant women: Limited data—not recommended unless necessary.
• Breastfeeding mothers: Avoid breastfeeding while taking Clarithromycin, as it may pass into breast milk.

✔️ Precautions & Warnings

• Discontinue if allergic reactions occur (severe hypersensitivity).
• QT Prolongation Risk: Avoid in patients with heart conditions or those taking QT-prolonging medications.
• Hepatitis Risk: Stop use immediately if signs of liver damage appear.
• Heart Disease Patients: There is a higher risk of mortality after Clarithromycin treatment—risk vs. benefit should be assessed.
• Clostridium difficile Infection Risk: If severe diarrhea occurs, check for C. difficile infection.
• Myasthenia Gravis: May cause worsening symptoms in patients with neuromuscular disorders.

✔️ Storage Instructions

• Store in a cool, dry place, away from light & moisture.
• Reconstituted suspension:
  • Use within 7 days at room temperature.
  • Use within 14 days if refrigerated.
• Keep out of reach of children.