Полусинтетический антибиотик группы макролидов. Подавляет си... Инструкция
Показания к применению
Инфекционно-воспалительные заболевания, вызванные чувствительными к кларитромицину микроорганизмами: инфекции нижних дыхательных путей (такие как бронхит, пневмония); инфекции верхних дыхательных путей (такие как фарингит, синусит); инфекции кожи и мягких тканей (такие как фолликулит, воспаление подкожной клетчатки, рожа).
Противопоказания
Повышенная чувствительность к кларитромицину, макролидам и другим компонентам препарата; одновременный прием кларитромицина со следующими препаратами: астемизол, цизаприд, пимозид, терфенадин (см. раздел «Взаимодействие с другими лекарственными препаратами»); одновременный прием кларитромицина с алкалоидами спорыньи, например, эрготамин, дигидроэрготамин ...
Полусинтетический антибиотик группы макролидов. Подавляет синтез белков в микробной клетке, взаимодействуя с 50S рибосомальной субъединицей бактерий. Действует в основном бактериостатически, а также бактерицидно. Активен в отношении грамположительных бактерий: Streptococcus spp., Staphylococcus spp., Listeria monocytogenes, Corynebacterium spp.; грамотрицательных бактерий: Helicobacter pylori, Haemophilus influenzae, Haemophilus ducreyi, Moraxella catarrhalis, Bordetella pertussis, Neisseria gonorrhoeae, Neisseria meningitidis, Borrelia burgdorferi; анаэробных бактерий: Eubacterium spp., Peptococcus spp., Propionibacterium spp., Clostridium perfringens, Bacteroides melaninogenicus; внутриклеточных микроорганизмов: Legionella pneumophila, Chlamydia trachomatis, Chlamydophila pneumoniae, Ureaplasma urealyticum, Mycoplasma pneumoniae. Активен также в отношении Toxoplasma gondii, Mycobacterium spp. (кроме Mycobacterium tuberculosis).
Показания к применению
Инфекционно-воспалительные заболевания, вызванные чувствительными к кларитромицину микроорганизмами: инфекции нижних дыхательных путей (такие как бронхит, пневмония); инфекции верхних дыхательных путей (такие как фарингит, синусит); инфекции кожи и мягких тканей (такие как фолликулит, воспаление подкожной клетчатки, рожа).
Противопоказания
Повышенная чувствительность к кларитромицину, макролидам и другим компонентам препарата; одновременный прием кларитромицина со следующими препаратами: астемизол, цизаприд, пимозид, терфенадин (см. раздел «Взаимодействие с другими лекарственными препаратами»); одновременный прием кларитромицина с алкалоидами спорыньи, например, эрготамин, дигидроэрготамин (см. раздел «Взаимодействие с другими лекарственными препаратами»); одновременный прием кларитромицина с мидазоламом для перорального применения (см. раздел «Взаимодействие с другими лекарственными препаратами»); одновременный прием кларитромицина с ингибиторами ГМГ-КоА-редуктазы (статинами), которые в значительной степени метаболизируются изоферментом CYP3A4 (ловастатин или симвастатин), в связи с повышением риска миопатии, включая рабдомиолиз (см. раздел «Взаимодействие с другими лекарственными препаратами»); одновременный прием кларитромицина с колхицином (см. раздел «Взаимодействие с другими лекарственными препаратами»); одновременный прием кларитромицина с тикагрелором или ранолазином; удлинение интервала QT в анамнезе (врожденное или приобретенное зарегистрированное удлинение интервала QT) или желудочковая аритмия, включая желудочковую тахикардию или желудочковая тахикардия типа «пируэт» (см. разделы «Особые указания» и «Взаимодействие с другими лекарственными препаратами»); гипокалиемия (риск удлинения интервала QT); тяжелая печеночная недостаточность, протекающая одновременно с почечной недостаточностью; холестатическая желтуха/гепатит в анамнезе, развившиеся при применении кларитромицина (см. раздел «Особые указания»); непереносимость галактозы, недостаточность лактазы, синдром мальабсорбции глюкозы-галактозы; порфирия; период грудного вскармливания; возраст до 12 лет (эффективность и безопасность не установлены).
С осторожностью
Почечная недостаточность средней степени тяжести; печеночная недостаточность средней и тяжелой степени; пациенты с ишемической болезнью сердца (ИБС), тяжелой сердечной недостаточностью, гипомагниемией, нарушениями проводимости или клинически значимой брадикардией.
Применение при беременности и в период грудного вскармливания
Безопасность применения кларитромицина во время беременности и в период грудного вскармливания не установлена. Применение кларитромицина при беременности (особенно в I триместре) возможно только в случае, когда отсутствует альтернативная терапия, а потенциальная польза для матери превышает потенциальный риск для плода. При необходимости приема в период лактации, грудное вскармливание необходимо прекратить.
Способ применения и дозы
Внутрь. Таблетки Клацид СР не разламывать и не разжевывать, их необходимо проглатывать целиком. Взрослым и детям старше 12 лет – по 1 таблетке (500 мг) 1 раз в день во время еды. При тяжелых инфекциях дозу увеличивают до 2 таблеток (1000 мг) 1 раз в день во время еды. Обычная продолжительность лечения от 5 до 14 дней. Исключение составляют внебольничная пневмония и синусит, которые требуют лечения от 6 до 14 дней.
Нарушения функции почек: для пациентов с почечной недостаточностью тяжелой степени (клиренс креатинина менее 30 мл/мин) обычная рекомендуемая доза составляет 250 мг один раз в сутки, в этом случае возможно применение препарата Клацид таблетки покрытые пленочной оболочкой, 250 мг. При более тяжелых инфекциях рекомендуемая доза составляет одна таблетка 500 мг с пролонгированным высвобождением кларитромицина. У пациентов с почечной недостаточностью средней степени тяжести (клиренс креатинина от 30 до 60 мл/мин) коррекция дозы не требуется.
Применение у детей младше 12 лет: применение кларитромицина в виде таблеток у детей младше 12 лет не изучалось.
Побочное действие
Сыпь; головная боль, бессонница; интенсивное потоотделение; диарея, рвота, диспепсия, тошнота, боль в области живота; дисгевзия; вазодилатация; отклонение в печеночной пробе. Перечень всех побочных эффектов представлен в инструкции по медицинскому применению.
Передозировка
Симптомы: прием большой дозы кларитромицина может вызывать симптомы нарушений со стороны желудочно-кишечного тракта. У одного пациента с биполярным расстройством в анамнезе после приема 8 г кларитромицина описаны изменения психического состояния, параноидальное поведение, гипокалиемия и гипоксемия.
Взаимодействие с другими лекарственными средствами
Антиаритмические средства (хинидин и дизопирамид): возможно возникновение желудочковой тахикардии типа «пируэт» при совместном применении кларитромицина и хинидина или дизопирамида. При совместном применении кларитромицина и пероральных гипогликемических средств (например, производные сульфонилмочевины) и/или инсулина может наблюдаться выраженная гипогликемия; рекомендуется тщательный контроль концентрации глюкозы.
Особые указания
Возможно развитие перекрестной резистентности к кларитромицину и другим антибиотикам группы макролидов, а также линкомицину и клиндамицину. В некоторых наблюдательныхисследованиях был установлен кратковременный риск развития аритмии, инфаркта миокарда и смерти от сердечно-сосудистых заболеваний, связанных с применением макролидов, включая кларитромицин.
Влияние на способность управлять автомобилем и движущимися механизмами
Данные относительно влияния кларитромицина на способность к управлению автомобилем и механизмами отсутствуют. Следует соблюдать осторожность при управлении транспортными средствами и механизмами, учитывая потенциальную возможность головокружения, вертиго, спутанности сознания и дезориентации, которые могут возникнуть при применении данного препарата.
Срок годности
3 года.
Условия отпуска
По рецепту.
Полная информация представлена в инструкции по медицинскому применению.
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