Klabax®
When used simultaneously with astemizole, cisapride, pimozide, terfenadine
an increase in the concentration of the latter in the blood has been reported, which can lead to cardiac arrhythmias (prolongation of the QT interval on the electrocardiogram, ventricular tachycardia, ventricular fibrillation, torsade de pointes). The simultaneous use of clarithromycin with astemizole, cisapride, pimozide, terfenadine is contraindicated.
Concomitant use of clarithromycin and ergotamine or dihydroergotamine
(ergot alkaloids) can lead to acute ergotamine intoxication, accompanied by severe peripheral vasospasm (impaired sensitivity, paresthesia, pain and a marked decrease in pulsation in the extremities, disorders of the central nervous system - dizziness, convulsions, coma).
Concomitant use of clarithromycin with ergot alkaloids
contraindicated.
Caution should be exercised when using clarithromycin concomitantly with ototoxic drugs, primarily aminoglycosides.
, due to increased ototoxicity. During and after treatment, the function of the hearing organ and vestibular apparatus should be monitored.
Concomitant use of zidovudine
in HIV-infected adult patients may result in decreased steady-state zidovudine concentrations. Since clarithromycin affects the absorption of concomitantly administered oral zidovudine, it is recommended that these drugs be taken at least 4 hours apart.
Clarithromycin inhibits the P-glycoprotein transporter, the substrate of which is digoxin
. When using clarithromycin and digoxin simultaneously, the concentration of digoxin in the blood plasma should be carefully monitored (its concentration may increase and the development of potentially fatal cardiac arrhythmias may occur).
Interactions due to CYP3A isoenzymes
Drugs that are inducers of the CYP3A4 isoenzyme (for example, rifampicin, phenytoin, carbamazepine, phenobarbital, St. John's wort) can induce the metabolism of clarithromycin. This may result in subtherapeutic concentrations of clarithromycin, resulting in reduced effectiveness. In addition, it is necessary to monitor the concentration of the CYP3A inducer in the blood plasma, which may increase due to the inhibition of the CYP3A isoenzyme by clarithromycin.
The following drugs have a proven or suspected effect on clarithromycin plasma concentrations; if they are used together, adjustment may be required and switching to alternative treatment.
Efavirenz, nevirapine, rifampicin, rifabutin, rifapentine
increase the metabolism of clarithromycin, reducing its concentration in the blood plasma and increasing the concentration of its biologically active metabolite 14-hydroxyclarithromycin. In patients receiving inducers of CYP3A isoenzymes, alternative antibiotic therapy options should be considered. The simultaneous use of clarithromycin and rifabutin leads to an increase in the concentration of rifabutin and a decrease in the concentration of clarithromycin in the blood plasma with the risk of developing uveitis.
Clarithromycin concentrations are reduced when etravirine
, but the concentration of the active metabolite 14-hydroxyclarithromycin increases.
Because 14-hydroxyclarithromycin has little activity against Mycobacterium avium complex
(MAC) infections, overall activity against Mycobacterium avium complex (MAC) infections may vary and alternative treatments should be considered for the treatment of MAC.
Concomitant use of fluconazole
leads to an increase in the equilibrium concentration and area under the curve of “conconcurrent” ventricular tachycardia. Monitoring of ECG (increased QT interval) and serum concentrations of these drugs is necessary. Cases of hypoglycemia have been reported with the combined use of clarithromycin and disopyramide. It is necessary to monitor the concentration of glucose in plasma during simultaneous use of these drugs.
Concomitant use with HMG-Co A reductase inhibitors
(simvastatin, lovastatin) leads to an increased risk of developing myopathy and rhabdomyolysis. Concomitant use of clarithromycin with simvastatin and lovastatin is contraindicated.
Clarithromycin should be used with caution in combination therapy with other statins. If co-administration with statins is necessary, statins that do not depend on CYP3A metabolism (for example, fluvastatin) should be used. It is recommended to take the lowest dose of statin. The development of signs and symptoms of myopathy should be monitored.
With the simultaneous use of clarithromycin and blockers of “slow” calcium channels
that are metabolized by the CYP3A4 isoenzyme (for example, verapamil, amlodipine, diltiazem), caution should be exercised as there is a risk of arterial hypotension. Plasma concentrations of clarithromycin, as well as blockers of “slow” calcium channels, may increase with simultaneous use. Arterial hypotension, bradyarrhythmia and lactic acidosis are possible when taking clarithromycin and verapamil simultaneously.
Colchicine
is a substrate for both CYP3A and P-glycoprotein, which are inhibited by clarithromycin. A single dose of 0.6 mg colchicine combined with clarithromycin 250 mg twice daily for a week resulted in an increase in the maximum concentration of colchicine by 197% and the area under the conconcentration-time curve and the steady-state concentration of saquinavir by 177% and 187%, respectively, and clarithromycin by 40%. When these two drugs are used simultaneously for a limited time in the doses and dosage forms indicated above, no dose adjustment is required. The results of drug interaction studies using saquinavir in soft gelatin capsules may not be consistent with the effects observed with saquinavir in hard gelatin capsules. The results of drug interaction studies with saquinavir monotherapy may not be consistent with the effects observed with saquinarine/ritonavir therapy. When taking saquinavir with ritonavir, consider the potential effect of ritonavir on clarithromycin.
Compound
One Klabax tablet may contain 250 or 500 mg. clarithromycin (an active drug). As auxiliary compounds, the drug contains substances such as: povidone, silicon dioxide, MCC, AC-DI-Sol (croscarmellose sodium), purified talc, magnesium stearate and stearic acid .
The film coating of the drug contains: hyprolose, titanium dioxide, hypromellose, sorbitan monooleate, yellow quinoline varnish CI N 47005, purified water and talc, as well as propylene glycol.
The ink used to write on the tablet includes substances such as: glazed shellac, propylene glycol, black iron oxide, N-butyl alcohol, purified water and isopropyl alcohol.
One tablet of Klabax OD prolonged action may contain 500 mg. medicinal compound clarithrocin , as well as excipients such as hypromelose, povidone, magnesium stearate, silicon dioxide (colloidal), lactolose monohydrate, talc and sodium stearyl fumarate.
The film coating of Klabaks OD tablets contains yellow dye 20N52875 Opadry (titanium dioxide, yellow quinoline, talc, hypromellose, vanillin, hyprolose and propylene glycol). The ink used for writing includes esterified shellac, Opacode-S-1-17734 ink, black iron oxide, propylene glycol, ammonium hydroxide, and methanol.
Side effects
Among the most common side effects of these drugs are the following ailments: abdominal pain, nausea, dizziness, diarrhea, dispersion, colitis, taste disturbance, headaches, as well as increased activity of liver enzymes, insomnia, depression, tinnitus, disorientation and confusion.
During the use of drugs, it is extremely rare, but such side effects of drugs may also occur: paresthesia, jaundice, nephritis, skin rash, Stevens-Johnson syndrome, urticaria, anaphylactic shock, leukopenia, hallucinations, arrhythmia or ventricular tachycardia.
Contraindications
Both drugs have the following contraindications:
- porphyria;
- age up to 12 years;
- hypersensitivity to substances included in the preparations, as well as to antibiotics ;
- first trimester of pregnancy ;
- liver dysfunction;
- use in the therapeutic treatment of ergot derivatives and some other drugs, for example, Pomozidom, Terfenadine, cisapride and Astemizole.
Reviews about Klabaks
People who have experienced the effectiveness of these antibiotics , for the most part, leave mixed reviews on Klabaks OD and Klabaks. It's all about the side effects of medications, which sometimes appear on the second day of taking the medication.
Most often, patients complain of dizziness, nausea and vomiting , as well as bitterness in the mouth . Thus, often these drugs do not even have time to sufficiently demonstrate their distinctive medicinal properties, since patients are forced to interrupt therapeutic treatment.
Klabaksa price, where to buy
The price of Klabax OD depends on the form of release of the drug and varies from 300 (pack, 1 blister, 7 tablets of 500 mg.) to 600 rubles (pack, 2 blisters, 14 tablets of 500 mg.) per package of the drug.
Average price of Klabax 500 mg. (packaging, 1 blister, 5, 10 and 14 coated tablets) is 250, 350 and 600 rubles, respectively.
- Online pharmacies in RussiaRussia
- Online pharmacies in UkraineUkraine
ZdravCity
- Klabax tablets p.p.o.
500 mg 14 pcs. Sun Pharmaceutical Industries Ltd. 384 rub. order - Klabax OD tablets p.p.o. 500mg 7 pcs Sun Pharmaceutical Industries Ltd
RUB 286 order
- Klabax OD tablets p.p.o. 500 mg 14 pcs. Sun Pharmaceutical Industries Ltd.
RUR 509 order
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Pharmacy24
- Klabax OD 500 mg No. 5 tablets Sun Pharmaceutical Industries Ltd., India
92 UAH.order
Klabax's analogs
Level 4 ATC code matches:
Ecositrin
Azicine
Rovamycin
AzitRus
Safocid
Clarithromycin
Sumamed Forte
Klarbakt
Azithromycin
Azitro Sandoz
Sumamed
ZI-Factor
Azitral
Azimed
Azicide
Spiramycin-vero
Zitrolide
Ecomed
Macropen
Klacid SR
The main analogues of Klabax can be considered:
- Arvicin;
- Binoculars;
- Clarithromycin-Verte;
- Clarbuckt;
- Clubax OD;
- Clarithromycin-Teva;
- Zimbaktar;
- Clarithromycin SR;
- Arvicin retard;
- Clarithromycin-Protekh;
- Clarithromycin Pfizer;
- Seydon-Sanovel;
- Kispar;
- Clarithromycin;
- CP-Klaren;
- Klacid;
- Claricite;
- Clarithromycin retard -OBL
- Romiclar;
- Fromilid uno;
- Arvicin retard;
- Crixan;
- Fromilid;
- Clerimed;
- Clarithromycin Zentiva;
- Coater;
- Klasine;
- Ecositrin;
- Clarithromycin-OBL;
- Clarithrosin;
- Fromilid uno.
Indications for use
So, what does Klabax (Klabax OD) help with or what diseases is this drug used to treat:
- upper respiratory tract infections caused by the negative effects of sensitive harmful microorganisms , for example, sinusitis, laryngitis, tonsillitis and pharyngitis ;
- infections caused by such harmful microorganisms as: Mycobacterium fortuitum, Mycobacterium intracellulare, Mycobacterium kansasii, Mycobacterium avium, and Mycobacterium chelonae;
- stomach ulcer;
- infections affecting soft tissues , and also the skin , for example, furunculosis, wound infection, folliculitis and impetigo;
- lower respiratory tract infections ( pneumonia, bronchitis );
- duodenal ulcer caused by Helicobacter pylori eradication;
- mycobacteriosis;
- chlamydia.
During pregnancy (and lactation)
The use of medications in the first trimester of pregnancy is strictly prohibited. In the future, drugs can be prescribed only in cases where there is an urgent medical need for their use. This means that the use of these drugs can be justified by the expected benefit to the mother, which will significantly exceed the possible negative consequences for the development of the fetus.
While using these medications, doctors recommend stopping breastfeeding .
