Bicrolid Special Precautions

Clarithromycin should not be used in pregnant women except in clinical circumstances where no alternative therapy is appropriate.
It should be given with caution in nursing mothers.
Pseudomembranous colitis has occurred with nearly all anti-bacterial agents, including macrolides. It is important to consider this diagnosis in patients who present with diarrhea subsequent to the administration of the drug.
Treatment with anti-bacterial agents alters the normal flora of the colon and may permit overgrowth of clostridia. Studies indicate that a toxin produced by Clostridium difficile is a primary cause of anti-biotic-associated colitis.
Safety and effectiveness of Clarithromycin in children under 12 years of age have not been established.
Prolonged cardiac repolarization and QT interval, imparting a risk of developing cardiac arrhythmia and torsades de pointes, have been seen in treatment with macrolides, therefore caution is required when treating: Patients with congenital or documented QT prolongation, patients currently receiving treatment with other active substances known to prolong QT interval such as antiarrhythmics of classes IA and Ill; antipsychotic agents; antidepressants; and fluoroquinolones.
Patients with electrolyte disturbance, particularly in cases of hypokalaemia and hypomagnesemia.
Patients with clinically relevant bradycardia, cardiac arrhythmia or cardiac insufficiency.
Elderly patients: Elderly patients may be more susceptible to drug-associated effects on the QT interval.