Discontinue use if allergic reaction occurs; if liver dysfunction has emerged; if signs & symptoms of hepatitis occur. Not intended for suitable severe infections where fast high blood conc of antibiotic have to be achieved. Serious allergic reactions, including angioneurotic oedema & anaphylaxis, & dermatologic reactions including acute generalised exanthematous pustulosis, SJS, TEN, & DRESS. Fulminant hepatitis potentially leading to life-threatening liver failure; abnormal liver function, hepatitis, cholestatic jaundice, hepatic necrosis & failure. Pseudomembranous colitis.
Clostridium difficile associated diarrhea. Prolonged cardiac repolarization & QT interval imparting risk of developing cardiac arrhythmia & Torsades de Pointes. Exacerbations of myasthenia gravis symptoms & new onset of myasthenia syndrome. Patients w/ congenital or documented QT prolongation; currently receiving treatment w/ other active substances known to prolong QT interval eg, class IA (quinidine & procainamide) & class III (dofetilide, amiodarone & sotalol) antiarrhythmics, cisapride & terfenadine, antipsychotic agents eg, pimozide, antidepressants eg, citalopram, & fluoroquinolones eg, moxifloxacin & levofloxacin; electrolyte disturbance, particularly hypokalaemia & hypomagnesemia; clinically relevant bradycardia, cardiac arrhythmia or severe cardiac insufficiency; neurological & psychiatric disorder. Long-term use. Perform LFTs/investigations in case of signs & symptoms of liver dysfunction eg, rapid developing asthenia associated w/ jaundice, dark urine, bleeding tendency or hepatic encephalopathy. Observe for signs of superinfection w/ non-susceptible organisms. Not to be co-administered w/ ergot derivatives. Not recommended in erythromycin-resistant gm +ve strains & most strains of methicillin resistant staphylococci. May affect ability to drive or operate machinery. Severe renal impairment (GFR <10 mL/min). Significant hepatic disease. Pregnancy & lactation. Neonates (risk of infantile hypertrophic pyloric stenosis). Childn (prevention or treatment of MAC). Elderly.
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