Pharmaniaga Clarithromycin Contraindications

Clarithromycin is contraindicated in patients with a known hypersensitivity to clarithromycin, erythromycin or any of the macrolide antibiotics.
Concomitant administration of clarithromycin with cisapride, pimozide or terfenadine is contraindicated. Clarithromycin and ergot derivatives should not be administered.
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 appraised 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 2-17 times the serum levels achieved in humans treated at the maximum recommended human doses.
There have been reports of an interaction between erythromycin and astemizole resulting in QT prolongation and torsade de pointes. Concomitant administration of erythromycin and astemizole is contraindicated. Because clarithromycin is also metabolised by cytochrome P450, concomitant administration of clarithromycin with astemizole is not recommended.
Concomitant administration of clarithromycin and the following drugs is contraindicated: Domperidone as this may result in QT prolongation and cardiac arrhythmias including ventricular tachycardia, ventricular fibrillation, and torsades de pointes (See Interactions.)