Dizziness clarithromycin

Buspirone (BuSpar) [Anxiolytic] WARNING Closely monitor for worsening depression or emergence of suicidality Uses Short-term relief of anxiety Action Antianxiety antagonizes CNS serotonin receptors Dose Initial 7.5 mg PO bid T by 5 mg q2-3d to effect usual 20-30 mg/d max 60 mg/d Contra w/ MAOI Caution [B, /-] Avoid w/ severe hepatic/renal insuff Disp Tabs SE Drowsiness, dizziness, HA, N, EPS, serotonin synd, hostility, depression Notes No abuse potential or physical/psychologic d endence Interactions T Effects W/ erythromycin, clarithromycin, itraconazole, ketoconazole, diltiazem, verapamil, grapefruit juice effects W/ carbamazepine, rifampin, phenytoin, dexamethasone, phenobarbital, fluoxetine EMS T Sedation w/ concurrent EtOH use grapefruit juice may T risk of adverse effects OD May cause dizziness, miosis, N/V symptomatic and supportive... 

Efavirenz (Sustiva) [Antiretroviral/NNRTI] Uses Hiv infxns Action Antiretroviral nonnucleoside RTI Dose Adults. 600 mg/d PO qhs Feds. See package insert avoid high-fat meals Caution [D, ] CDC recommends HIV-infected mothers not breast-feed Contra Component sensitivity Disp Caps SE Somnolence, vivid dreams, dizziness, rash, N/V/D Interactions T Effects W/ ritonavir T effects OF CNS depressants, ergot derivatives, midazolam, ritonavir, simvastatin, triazolam, warfarin X effects W/ carbamazepine, phenobarbital, rifabutin, rifampin, saquinavir, St. John s wort i effects OF amprenavir, carbamazepine, clarithromycin, indinavir, phenobarbital, saquinavir, warfarin may alter effectiveness OF OCPs EMS Concurrent EtOH usage can t CNS d ression OD May cause muscle contractions and adverse CNS effects activated charcoal may be effective... 

ALMOTRIPTAN, ELETRIPTAN MACROLIDES -CLARITHROMYCIN, ERYTHROMYCIN, TELITHROMYCIN t plasma concentrations of almotriptan and eletriptan, with risk of toxic effects, e.g. flushing, sensations of tingling, heat, heaviness, pressure or tightness of any part of body including the throat and chest, dizziness Almotriptan is metabolized mainly by CYP3A4 isoenzymes. Most CYP isoenzymes are inhibited by clarithromycin to varying degrees, and since there is an alternative pathway of metabolism by MAO-A, toxicity responses will vary between individuals Avoid co-administration... 

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... 

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. 

In a multicenter, double-blind, randomized comparison of trovafloxacin 200 mg and clarithromycin 500 mg bd in 176 subjects with acute exacerbations of chronic bronchitis, the most common adverse effects of trovafloxacin were nausea (5%), dizziness (5%), vomiting (3%), and constipation (3%) (1). Because trovafloxacin is hepato-toxic, the list of appropriate indications has been limited to patients who have at least one of several specified infections, such as nosocomial pneumonia or complicated intra-abdominal infections that are serious and life- or limb-threatening in the physician s judgement. 

Data from 20 clinical studies in 5000 patients who had taken ranitidine bismuth citrate (200, 400, or 800 mg bd) have been reported (14). The incidence of adverse events was not different from that associated with placebo and was independent of dose. The most common events (>1% of patients) were upper respiratory tract infections, constipation, diarrhea, nausea, vomiting, dizziness, and headache, the last being the only event reported by over 2% of the patients. Adverse events considered by the chnical investigator to be adverse reactions occurred with a similar frequency amongst patients given ranitidine bismuth citrate (8%), ranitidine hydrochloride (6%), and placebo (6%). The incidence of adverse reactions was greater when amoxicillin (11%) or clarithromycin (20%) were co-prescribed. 

Carbamazepine toxicity, with dizziness, lethargy, and nystagmus, developed in a 17-year-old boy two days after he started to take clarithromycin 500 mg/day (129). His serum carbamazepine concentration (previously acceptable) rose, but returned to within the target range after withdrawal of clarithromycin. 

A 53-year-old woman had periods of dizziness and episodes of fainting when she stood np 24 hours after having been given clarithromycin for an acute exacerbation of chronic obstmctive pnlmonary disease and verapamil for atrial fibrillation (32). One day later she developed severe hypotension and bradycardia (32). Since her symptoms matched those of severe verapamil overdosage, the drug was withdrawn and her condition improved within two days. 

The interaction between carbamazepine and clarithromycin is also established, clinically important and potentially serious. However, the extent of the interaction is less with clarithromycin than with erythromycin or troleandomycin (i.e. the rise in carbamazepine levels is less)." It has been recommended that carbamazepine dosages should be reduced by 30 to 50% during treatment with clarithromycin, with monitoring within 3 to 5 days, and patients should be told to tell their doctor of any symptoms of toxicity (dizziness, diplopia, ataxia, mental confusion). 

Clarithromycin (as macrolide antibiotics) has many side effects linked to its consumption, including abnormal taste, diarrhea, headache, indigestion, nausea, stomach pain, and vomiting (Chey and Wong, 2007 Khoshnood et al., 2014). Other common side effects can include headaches, hallucinations, dizziness, and rash. In rare cases, the medication may cause jaundice or kidney problems (Fox et al., 2002). 

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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