Synclar

📦 Всяка поръчка е покрита от нашата Политика за повторна изпратка — ако вашата пратка не пристигне в рамките на 20 работни дни, ние я изпращаме отново.

Защо да поръчвате от MedsBase

Нашите генерични лекарства се доставят от производители, сертифицирани от WHO-GMP, и се изпращат по целия свят в дискретна, обикновена опаковка — без име на лекарството външно на пратката. Плащанията с карта се обработват чрез регулиран процесор (описанието на извлечението включва регулиран процесор за плащане с карта — никога “MedsBase” или име на лекарство). Приемат се също криптовалути и банков превод SEPA. Всяка поръчка е подкрепена от нашата политика за гарантирано преизпращане.

Защо да поръчвате от MedsBase

Synclar is supplied from a СЗО-GMP сертифициран производител. Every order ships discreetly worldwide and is covered by our Политика за повторна изпратка — if it does not arrive within 20 business days, we reship at no cost. Clarithromycin is the standard partner antibiotic in H. pylori first-line eradication and remains a first-choice agent for atypical pneumonia — well-established efficacy with broad guideline support.

Mechanism

Clarithromycin binds reversibly to the 23S rRNA in the 50S bacterial ribosomal subunit, blocking peptide elongation. It is bacteriostatic against most species and bactericidal at high concentrations against susceptible organisms. The drug penetrates well into respiratory tissue, gastric mucosa, macrophages, and bone. The primary metabolite (14-OH-clarithromycin) is also active and contributes to the spectrum. Resistance arises through 23S rRNA mutations and methylation; H. pylori resistance to clarithromycin now exceeds 20–30 percent in many regions.

Показания

• H. pylori eradication (first-line): clarithromycin 500 mg BD + amoxicillin 1 g BD + PPI BD for 14 days; substitute metronidazole if penicillin-allergic; substitute bismuth quadruple therapy where local clarithromycin resistance > 15 percent
• Community-acquired pneumonia (atypical or as part of combination therapy)
• Acute exacerbation of chronic bronchitis
• Streptococcal pharyngitis / tonsillitis (penicillin-allergic)
• Mycobacterium avium complex (MAC) prophylaxis and treatment in HIV / transplant
• Skin and soft-tissue infection (Staphylococcus, Streptococcus — if susceptible)
• Acute bacterial sinusitis

Доза

Adults: 250–500 mg twice daily for 7–14 days. H. pylori: 500 mg twice daily for 14 days as part of triple/quadruple therapy. MAC: 500 mg twice daily long-term. CrCl < 30: halve dose or extend interval. Severe hepatic impairment in setting of normal renal function: no change; in combined hepatic-renal: avoid. Children: weight-based 7.5 mg/kg twice daily (max 500 mg BD).

Странични ефекти

• GI: bitter / metallic taste, nausea, vomiting, diarrhoea, abdominal pain
• QT prolongation, torsades de pointes (rare; risk increases with concurrent QT-prolongers)
• Hepatotoxicity (rare; cholestatic hepatitis)
• C. difficile-associated diarrhoea
• Allergic reactions: rash, urticaria; rare Stevens-Johnson syndrome and DRESS
• Headache, dizziness, transient hearing loss (rare)
• Cardiovascular events on long-term use (slight signal in observational data)

Взаимодействия с лекарства

Clarithromycin inhibits CYP3A4 strongly. Many interactions; the most important:

• Statins (simvastatin, lovastatin, atorvastatin): rhabdomyolysis — suspend or switch to pravastatin / rosuvastatin / fluvastatin.
• Ergot alkaloids: ergotism (vasospasm) — absolute contraindication.
• Pimozide: torsades — absolute contraindication.
• Colchicine in renal impairment: fatal toxicity — absolute contraindication.
• Calcium-channel blockers: hypotension and AKI — reduce dose, monitor.
• Warfarin: INR rise — monitor.
• QT-prolonging drugs: additive risk — avoid combination.
• Combined OC pill: efficacy maintained for short courses.
• Carbamazepine, phenytoin: levels rise — monitor.
• Tacrolimus, ciclosporin: levels rise — monitor.
• Theophylline: levels rise.

Често задавани въпроси

How is the H. pylori triple therapy taken?

Standard regimen: clarithromycin 500 mg twice daily + amoxicillin 1 g twice daily + a PPI (omeprazole 20 mg, esomeprazole 40 mg, or equivalent) twice daily for 14 days. Take all three together to maximise eradication.

What if H. pylori comes back?

Re-test no earlier than 4 weeks after completing therapy and stopping the PPI 2 weeks before the test (urea breath test or stool antigen). If positive, switch to bismuth quadruple therapy (PPI + bismuth + tetracycline + metronidazole).

Can I drink alcohol on it?

Light alcohol is acceptable. Heavy alcohol increases hepatotoxicity risk.

Why does everything taste metallic?

A common known side effect of clarithromycin (~5 percent of patients). It resolves within days of finishing the course.

Is it safe in pregnancy?

Category C. Use only if benefit clearly outweighs risk; alternatives (amoxicillin alone, azithromycin) often available.

Will it interact with my statin?

Yes — simvastatin and lovastatin must be paused during clarithromycin (rhabdomyolysis risk). Atorvastatin should be reduced. Pravastatin, rosuvastatin, and fluvastatin are unaffected by CYP3A4 inhibition.

How is it different from azithromycin?

Azithromycin is a 15-membered azalide derived from erythromycin. It has weaker CYP3A4 inhibition (so fewer drug interactions), longer half-life (single-day or 5-day courses), and weaker activity against H. pylori. Clarithromycin remains preferred for H. pylori; azithromycin is preferred when CYP3A4 interactions or once-daily dosing matters.

Can children take it?

Yes, with weight-based dosing. Useful for paediatric atypical pneumonia and pertussis.

Can I take a probiotic with it?

Yes. Separate the probiotic from clarithromycin by 2 hours. Probiotics during and after the course reduce antibiotic-associated diarrhoea risk.

Съхранение

Below 25°C in a dry place. Keep tablets in the original blister.

Other Gastro Health Medications

• Famocid — Famotidine (H. pylori partner: H2 blocker)
• Omez — Omeprazole 20 mg (PPI partner)
• Rcifax — Rifaximin
• Cendox — Doxycycline (H. pylori salvage)
• Ciplox — Ciprofloxacin (H. pylori salvage)
• Browse all Gastro Health Medications

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