Synclar
Synclar (Clarithromycin 250/500 mg, Cipla) — macrolide antibiotic for H. pylori first-line eradication (with PPI + amoxicillin), atypical pneumonia, and MAC infection. Strong CYP3A4 inhibitor — check interactions. Worldwide shipping from MedsBase.
✓ Medisch beoordeeld door Morgan Ellis — Apotheekonderzoeker · 8 jaar ervaring · Laatst beoordeeld: mei 2026
⚡ Quick Answer — What is Synclar?
Synclar is clarithromycin 250 mg or 500 mg tablet from Cipla — a 14-membered macrolide antibiotic. In a gastro context it is the cornerstone of Helicobacter pylori first-line eradication as part of a triple-therapy regimen with a PPI and either amoxicillin or metronidazole for 14 days. Other indications include respiratory infection (community-acquired pneumonia, exacerbation of COPD), atypical pneumonia (Mycoplasma, Legionella, Chlamydophila), Mycobacterium avium complex (MAC), and skin / soft-tissue infection. Standard adult dose: 250–500 mg twice daily for 7–14 days. WHO-GMP certified manufacturer.
📦 Elke bestelling is gedekt door onze Reshipment Assurance Policy — als uw pakket niet binnen 20 werkdagen arriveert, sturen wij het opnieuw.
Waarom bestellen bij MedsBase
Onze generieke medicijnen zijn afkomstig van WHO-GMP gecertificeerde fabrikanten en worden wereldwijd verzonden in discrete, eenvoudige verpakkingen — geen medicijnnaam op de buitenkant van het pakket. Betalingen met kaart worden verwerkt via een gereguleerde processor (betalingsoverzichten vermelden een gereguleerde kaartbetalingprocessor — nooit “MedsBase” of een medicijnnaam). Crypto en SEPA bankoverschrijvingen worden ook geaccepteerd. Elke bestelling wordt ondersteund door ons Reshipment Assurance Policy.
Waarom bestellen bij MedsBase
Synclar is supplied from a WHO-GMP gecertificeerde fabrikant. Every order ships discreetly worldwide and is covered by our Reshipment Assurance Policy — 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.
Indicaties
- 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
Dosering
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).
Bijwerkingen
- 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)
Geneesmiddelinteracties
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.
Veelgestelde vragen
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.
Opslag
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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Gerangschikt op recente bestelvolumes van MedsBase — wat andere klanten in deze categorie kiezen.
| Sterkte | 250 mg, 500 mg |
|---|---|
| Hoeveelheid | 32 Tablet/s, 64 Tablet/s, 128 Tablet/s |
| Farmaceutische vorm | Tablet/s |
| Fabrikant | Cipla Inc |
| Behandeling | Maag-darmgezondheid |
| Generiek merk | Clarithromycin |
Synclar
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Synclar
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