Which drugs or supplements interact with Clarexid?
Clarexid interacts with several drugs because it reduces the activity of liver enzymes that breakdown many drugs. This leads to increased blood levels and side effects from the affected drugs. Examples of such interactions include
Clarexid increases blood levels of sildenafil (Viagra, Revatio), tadalafil (Cialis, Adcirca), vardenafil (Levitra), theophylline and carbamazepine (Tegretol), thereby increasing side effects of these drugs.
Ritonavir (Norvir) and atazanavir (Reyataz) increase blood levels of Clarexid while efavirenz (Sustiva), nevirapine (Viramune), rifampin, decrease blood levels of Clarexid.
Itraconazole (Sporanox) and saquinavir (Invirase) may increase blood levels of Clarexid while Clarexid increases blood levels or both drugs.
The occurrence of abnormal heart beats may increase when Clarexid is combined with drugs that affect heart beat (for example, amiodarone , quinidine , and disopyramide).
Concomitant administration of Clarexid and ritonavir (n = 22) resulted in a 77% increase in Clarexid AUC and a 100% decrease in the AUC of 14-OH Clarexid.Prevent:
- Disseminated MAC infection
The recommended uses may not always be consistent with FDA-approved uses of Clarexid. See the guidelines for complete information on recommended uses of Clarexid in adults and adolescents with HIV. Some recommended uses, such as uses in certain rare circumstances, may have been omitted above.
The following adverse reactions have been identified during post-approval use of BIAXIN. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.
Blood and Lymphatic System: Thrombocytopenia, agranulocytosis
Cardiac: Ventricular arrhythmia, ventricular tachycardia, torsades de pointes
Ear and Labyrinth: Deafness was reported chiefly in elderly women and was usually reversible.
Gastrointestinal: Pancreatitis acute, tongue discoloration, tooth discoloration was reported and was usually reversible with professional cleaning upon discontinuation of the drug.
There have been reports of BIAXIN XL Filmtab in the stool, many of which have occurred in patients with anatomic (including ileostomy or colostomy) or functional gastrointestinal disorders with shortened GI transit times. In several reports, tablet residues have occurred in the context of diarrhea. It is recommended that patients who experience tablet residue in the stool and no improvement in their condition should be switched to a different Clarexid formulation (e.g. suspension) or another antibacterial drug.
Hepatobiliary: Hepatic failure, jaundice hepatocellular. Adverse reactions related to hepatic dysfunction have been reported with Clarexid .
Infections and Infestations: Pseudomembranous colitis
Immune System: Anaphylactic reactions, angioedema
Investigations: Prothrombin time prolonged, white blood cell count decreased, international normalized ratio increased. Abnormal urine color has been reported, associated with hepatic failure.
Metabolism and Nutrition: Hypoglycemia has been reported in patients taking oral hypoglycemic agents or insulin.
Musculoskeletal and Connective Tissue: Myopathy rhabdomyolysis was reported and in some of the reports, Clarexid was administered concomitantly with statins, fibrates, colchicine or allopurinol .
Nervous System: Parosmia, anosmia, ageusia, paresthesia and convulsions
Psychiatric: Abnormal behavior, confusional state, depersonalization, disorientation, hallucination, depression, manic behavior, abnormal dream, psychotic disorder. These disorders usually resolve upon discontinuation of the drug.
Renal and Urinary: Nephritis interstitial, renal failure
Skin and Subcutaneous Tissue: Stevens-Johnson syndrome, toxic epidermal necrolysis, drug rash with eosinophilia and systemic symptoms (DRESS), Henoch-Schonlein purpura, acne, acute generalized exanthematous pustulosis
Do Other Drugs Affect the Way Clarexid Works?
Clarexid may interact with several medications because it reduces the activity of liver enzymes that break down many drugs. Some examples of medicines that may interact with Clarexid include:
Clarexid increases blood levels of sildenafil (Viagra, Revatio), tadalafil (Cialis, Adcirca), vardenafil (Levitra), theophylline (Theolair), and carbamazepine (Tegretol), which can increase the side effects of these drugs.
Ritonavir (Norvir) and atazanavir (Reyataz) increase blood levels of Clarexid.Efavirenz (Sustiva), nevirapine (Viramune), and rifampin (Rifadin) decrease blood levels of Clarexid.
Itraconazole (Sporanox) and saquinavir (Invirase) may increase blood levels of Clarexid, while Clarexid increases blood levels of both drugs.
Abnormal heartbeats may occur when Clarexid is combined with some drugs, such as amiodarone (Cordarone), quinidine (Quinidex), amitriptyline (Elavil), fluconazole (Diflucan), citalopram (Celexa), trazodone (Oleptro), or disopyramide (Norpace).
In a steady-state study in which healthy elderly subjects (65 years to 81 years of age) were given 500 mg of BIAXIN every 12 hours, the maximum serum concentrations and area under the curves of Clarexid and 14-OH Clarexid were increased compared to those achieved in healthy young adults. These changes in pharmacokinetics parallel known age-related decreases in renal function. In clinical trials, elderly patients did not have an increased incidence of adverse reactions when compared to younger patients. Consider dosage adjustment in elderly patients with severe renal impairment. Elderly patients may be more susceptible to development of torsades de pointes arrhythmias than younger patients .
Most reports of acute kidney injury with calcium channel blockers metabolized by CYP3A4 (e.g., verapamil, amlodipine, diltiazem, nifedipine) involved elderly patients 65 years of age or older .
Especially in elderly patients, there have been reports of colchicine toxicity with concomitant use of Clarexid and colchicine, some of which occurred in patients with renal insufficiency. Deaths have been reported in some patients .
Rated Clarexid for Pharyngitis Report
I had a restricted oesophagus and an infection due to lodged food. I had a fever and had penicillin for 10 days but it had not cleared up and went to the doctor to get more antibiotics. Due to stomach side affects and problems swallowing tablets I asked for an alternative and was prescribed liquid Clarexid. I read the LONG list of side effects and was a bit worried about the 'throat inflammation' side effect since that was my main symptom already. First day was OK but had appetite suppression but throat seemed worse rather than better. On 2nd night, I woke up with a severe anxiety attack at 2 a.m. - very panicky. It was like I was schizophrenic! Half of my mind was saying 'look - you are not dying and you can breath OK' - the other half was saying 'I feel terrible, my throat feels terrible and I really believe I am dying'. After an hour or so I calmed myself down and went to sleep. The next morning I had a shower and got dressed. Then I suddenly had a panic attack again (never had these before except once when scuba diving for first time!). Felt too ill to drive and could hardly walk. Hyperventilating so much I nearly fainted a few times. Rang my brother to come and take me
Co-administration of BIAXIN is known to inhibit CYP3A, and a drug primarily metabolized by CYP3A may be associated with elevations in drug concentrations that could increase or prolong both therapeutic and adverse effects of the concomitant drug.
BIAXIN should be used with caution in patients receiving treatment with other drugs known to be CYP3A enzyme substrates, especially if the CYP3A substrate has a narrow safety margin (e.g., carbamazepine) and/or the substrate is extensively metabolized by this enzyme. Adjust dosage when appropriate and monitor serum concentrations of drugs primarily metabolized by CYP3A closely in patients concurrently receiving Clarexid.
Table 8: Clinically Significant Drug Interactions with BIAXIN