Clarithromycin

Iron and antacid (like magnesium hydroxide and aluminium hydroxide) may bind to Clarithromycin in the gastrointestinal tract, lowering its efficiency. So, a gap of at least 2 hours should be maintained between intake of Clarithromycin and iron supplements and antacids. Besides this, in some cases, the use of Clarithromycin causes antibiotic-associated diarrhoea. Clarithromycin may cause sensitive skin to sunlight and ultraviolet rays, causing an exaggerated sunburn reaction. Hence it is advisable to apply sunscreen before going outside. Its use has also been associated with an increased risk of fungal skin infections like (vaginal candidiasis - thrush). Tetracycline and Clarithromycin can form a stable calcium complex in bone-forming tissue, thereby affecting the growth of fibula bones in young children and bone development in the foetus. Using a Clarithromycin with isotretinoin should be avoided as it has been reported to cause pseudotumor cerebri (increased pressure inside the brain). Long-term use of Clarithromycin may affect your blood, kidney, and liver health, so yearly diagnostics test of these parameters is recommended.

Drug-Drug Interactions: Clarithromycin is contraindicated in persons who have shown hypersensitivity to certain antibiotics (such as azithromycin, amoxicillin/clavulanate), a statin medicine to lower your cholesterol (such as simvastatin and atorvastatin), medications used for blood thinners (such as warfarin), drugs used for heart problems (digoxin), certain medicines used for gout (colchicine), asthma medications (such as theophylline, budesonide/formoterol), medicines for epilepsy, (such as carbamazepine and phenytoin), and drugs used to treat migraines (such as ergotamine and dihydroergotamine).

Drug-Food Interactions: Food containing calcium and iron should be avoided as it may affect Clarithromycin effectiveness. Also, prevent the intake of grapefruit or grapefruit juice with Clarithromycin. Avoid alcohol intake as it may lead to drowsiness and affect Clarithromycin absorption.

Drug-Disease Interactions: Clarithromycin should not be given in people with liver or kidney problems, cardiovascular disorders (fast, pounding or irregular heartbeats), QT prolongation, Colitis (a chronic digestive disease characterized by inflammation of the inner lining of the colon), abnormally low levels of potassium in your blood and muscle disease (myasthenia gravis).

• Probiotics and prebiotics can also help to reduce the side effects of antibiotics.

• Include more fibre-enriched food in your diet, as it can be easily digested by your gut bacteria, which helps stimulate their growth. Thus, fibre foods may help restore healthy gut bacteria after a course of antibiotics. Whole grains like whole-grain bread and brown rice should be included in your diet. 

• Eating grapefruit during antibiotics treatment can prevent the body from utilizing Clarithromycin properly. So, avoid intake of grapefruit or grapefruit juice with the antibiotic. 

• Avoid taking too much calcium, iron-enriched foods and drinks as it might affect the working of Clarithromycin. 

• Avoid intake of alcoholic beverages with Clarithromycin as it can make you dehydrated and affect your sleep. This can make it harder for your body to aid the Clarithromycin in fighting off infections.

• Probiotics should be taken after taking the full course of Clarithromycin in order to restore some of the healthy bacteria in the intestines that may have been killed. Taking probiotics after antibiotic treatment can reduce the risk of antibiotic-associated diarrhoea. Certain fermented foods like yoghurt, cheese, sauerkraut, kombucha and kimchi can help restore the intestine's good bacteria.