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Children older than 12 years: As for adults.
Children younger than 12 years: Use Klacid Pediatric Suspension. The use of Klacid IR has not been studied in children less than 12 years of age.
Eradication of H. pylori (Adults): Triple Therapy Regimen: Clarithromycin 500 mg twice daily in conjunction with amoxicillin 1000 mg twice daily and a proton pump inhibitor in standard dose twice daily for seven days.
Dual Therapy Regimen: Clarithromycin 500 mg three times daily in conjunction with omeprazole 40 mg once daily for 14 days, followed by omeprazole 40 mg once daily for an additional 14 days. Supportive studies have been conducted with omeprazole 40 mg once daily for 14 days.
Elderly: As for adults.
Renal Impairment: In patients with renal impairment with creatinine clearance less than 30 ml/min, the dosage of clarithromycin should be reduced by one-half, i.e., 250mg once daily or 250mg twice daily in more severe infections. Treatment should not be continued beyond 14 days in these patients.
Klacid may be given without regard to meals as food does not affect the extent of bioavailability.
Klacid MR: Adults: The usual recommended dosage of Klacid MR in adults is one 500mg modified-release tablet daily to be taken with food. In more severe infections, the dosage can be increased to two 500mg modified-release tablets daily. The usual duration of treatment is 7 to 14 days.
Children older than 12 years: As for adults.
Children younger than 12 years: Use Klacid Pediatric Suspension. The use of Klacid MR has not been studied in children less than 12 years of age.
Klacid MR should not be used in patients with renal impairment (creatinine clearance less than 30 mL/min). Klacid immediate release tablets may be used in this patient population (see Contraindications).
Do not crush or chew Klacid MR tablets.
Renal Impairment: Clarithromycin modified release should not be used in patients with significant renal impairment (creatinine clearance less than 30 ml/min), as appropriate clarithromycin dosage reduction is not possible when administering this product. Clarithromycin immediate release tablets may be utilized in this patient population (see Contraindications). Refer the dosing for immediate release formulation.
Klacid Pediatric Suspension: Pediatric Patients 6 months to 12 years of age: Clinical trials have been conducted using Klacid pediatric suspension in children 6 months to 12 years of age. Therefore, children 6 months to 12 years of age should use Klacid pediatric suspension (granules for oral suspension).
The recommended daily dosage of Klacid Pediatric Suspension (125mg/5mL or 250mg/5mL) in children is 7.5 mg/kg b.i.d. up to a maximum dose of 500mg b.i.d. for non-mycobacterial infections. The usual duration of treatment is for five to ten days depending on the pathogen involved and the severity of the condition. The prepared suspension can be taken with or without meals, and can be taken with milk.
The following table is a suggested guide for determining dosage: (See Table 4.)
Click on icon to see table/diagram/imageDosage in Patients with Mycobacterial Infections: In children with disseminated or localized mycobacterial infections (M. avium, M. intracellulare, M. chelonae, M. fortuitum, M. kansasii), the recommended dose is 15 to 30mg/kg clarithromycin b.i.d not exceeding a maximum dose of 500 mg b.i.d.
Treatment with clarithromycin should continue as long as clinical benefit is demonstrated. The addition of other antimycobacterial agents may be of benefit. (See Table 5.)
Click on icon to see table/diagram/imagePreparations for use: See Special precautions for disposal and other handling under Cautions for Usage.
Renal Impairment: In children with creatinine clearance less than 30 ml/min/1.73m2, the dosage of clarithromycin should be reduced by one half, i.e. up to 250mg once daily, or 250mg twice daily in more severe infections. Dosage should not be continued beyond 14 days in these patients.
Klacid IV: Intravenous therapy may be given for 2 to 5 days and should be changed to oral clarithromycin therapy when appropriate. Klacid IV should be administered into one of the larger proximal veins as an IV infusion over 60 minutes using a solution concentration of about 2 mg/ml. Clarithromycin should be given as a bolus or an intramuscular injection.
Adults: The recommended dosage of Klacid IV in adults 18 years of age or older is 1.0 g daily divided into two 500 mg doses, appropriately diluted described as follows.
Pediatric: There are insufficient data to recommend a dosage regimen for use of the Klacid IV formulation in patients less than 18 years of age (see Klacid Pediatric Suspension as previously mentioned).
Renal Impairment: In patients with renal impairment who have creatinine clearance less than 30 ml/min, the dosage of clarithromycin should be reduced to one half of the normal recommended dose.
Preparation for Use: See Special precautions for disposal and other handling under Cautions for Usage.
