Abdominal pain clarithromycin

Clarithromycin 15 mg/kg per day in 2 doses (adult 250 mg twice daily) Diarrhea, vomiting, rash, abnormal taste, abdominal pain SJ Many drug interactions (inhibits cytochrome P-450 3A4) suspension cannot be refrigerated and has metallic taste same microbiologic issues as azithromycin... 

Erythromycin- sulfisoxazole 50 mg/kg per day of erythromycin component in 3 4 doses Nausea, vomiting, abdominal pain, diarrhea, rash SS Many drug interactions (like clarithromycin), contraindicated in children under 2 months increasing pneumococcal resistance... 

Clarithromycin Adverse reactions occurring in at least 3% of patients include abdominal pain, abnormal taste, diarrhea, increased BUN, nausea, and rash. Dirithromycin Adverse reactions occurring in at least 3% of patients include abdominal pain/discomfort, diarrhea/loose stools, headache, increased platelet counts, nausea, and vomiting. 

IMATINIB 1. ANTIBIOTICS - clarithromycin, erythromycin 2. ANTIFUNGALS -fluconazole, itraconazole, ketoconazole voriconazole 3. ANTIVIRALS -efavirenz, ritonavir 4. GRAPEFRUIT JUICE 5. H2 RECEPTOR BLOCKERS - cimetidine t imatinib levels with t risk of toxicity (e.g. abdominal pain, constipation, dyspnoea) and of neurotoxicity (e.g. taste disturbances, dizziness, headache, paraesthesia, peripheral neuropathy) Due to inhibition of CYP3A4-mediated metabolism of imatinib Monitor for clinical efficacy and for the signs of toxicity listed, along with convulsions, confusion and signs of oedema (including pulmonary oedema). Monitor electrolytes and liver function, and for cardiotoxicity... 

CLARITHROMYCIN, ERYTHROMYCIN VINCA ALKALOIDS -VINBLASTINE, VINCRISTINE, VINORELBINE t adverse effects of vinblastine and vincristine Inhibition of CYP3A4-mediated metabolism. Also inhibition of P-gp efflux of vinblastine Monitor FBCs. Watch for early features of toxicity (pain, numbness, tingling in the fingers and toes, jaw pain, abdominal pain, constipation, ileus). Consider selecting an alternative drug... 

Like erythromycin, the most common side effects of azithromycin and clarithromycin are gastrointestinal, with diarrhea, nausea, and abdominal pain being the most frequently reported. Clarithromycin can also cause headache and dyspepsia. Other side effects of azithromycin include palpitations, vaginitis, headache, dizziness, fatigue, and hypersensitivity reactions. 

Erjdhromycin acts as a motilin receptor agonist (27-29). This mechanism may be at least partly responsible for the gastrointestinal adverse effects of macrolides. Clarithromycin may act on gastrointestinal motility in a similar way. In dogs, clarithromycin caused contractions and discomfort, as did erythromycin (30). In healthy volunteers, oral clarithromycin 250 mg bd caused a statistically significant increase in the number of postprandial antral contractions and antral motility (31). A single oral dose of clarithromycin 3000 mg resulted in severe abdominal pain within 1 hour of administration in two patients (32). 

Dual therapy (omeprazole plus clarithromycin) for 2 weeks has been compared with triple therapy (omeprazole plus amoxicillin and clarithromycin) for 1 week in the eradication of H. pylori in 145 patients with duodenal nlcers (7). Triple therapy was significantly more effective in eradicating H. pylori (71 versus 48%). There were no significant differences in comphance or adverse effects. The most freqnent adverse effects were metallic taste and nansea in the dnal-therapy gronp and metalhc taste, mild abdominal pain, and diarrhea in the triple-therapy group. 

Sucralfate 1 g tds in combination with amoxicillin 500 mg tds and clarithromycin 400 mg bd for 2 weeks was as effective as a combination of lansoprazole 30 mg bd plus amoxicillin 500 mg tds and clarithromycin 400 mg bd for 2 weeks for H. pylori eradication in a randomized, multicenter trial in 150 patients (9). There was no significant difference in adverse effects between the two groups. Diarrhea, abdominal pain, glossitis, and taste disturbance were the adverse effects commonly reported. 

In a randomized, controlled trial in 120 patients supplementation with inactivated Lactobacillus acidophilus tds significantly improved the efficacy of a standard 7-day regimen with rabeprazole 20 mg bd, clarithromycin 250 mg tds, and amoxicillin 500 mg tds (12). There was no significant difference in adverse effects between the two groups. Those reported were abdominal pain, nausea, and diarrhea. 

The gastrointestinal adverse effects are the most common untoward effects of the macrolides (Table 2). Nausea and vomiting associated with abdominal pain and occasionally diarrhea can be minor and transitory or, in a small percentage of patients, become severe enough to result in premature withdrawal. The rate of these adverse effects varies among the different antibiotics. In general, newer macrolides, such as azithromycin, clarithromycin, or roxithromycin, are better tolerated and cause fewer adverse effects than erythromycin. 

A meta-analysis comparing telithromycin with clarithromycin reviewed data from five randomised controlled trials. Adverse events were similar in both groups. Common adverse events included diarrhoea, nausea, vomiting, flatulence, dyspepsia and abdominal pain. Other events included headache, oral candidiasis, dizziness, dysgeusia, abnormal liver function tests and fatigue. Serious adverse events included allergic reactions, abnormal liver function tests as well as death (in three cases) [86 ]. 

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