(clarithromycin · DailyMed)
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Clarithromycin USP 250mg, Omeprazole BP 20mg and Tinidazole BP 500mg
What it does
Clarithromycin is an antibiotic used to treat infections caused by bacteria.
Commonly used for: bacterial infections, chest infections (pneumonia), skin infections, ear infections (otitis media)
Read more in plain English ↓Plain-language summary for general understanding - not medical advice. Always follow your pharmacist/doctor.
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Answers come only from this medicine's registration record, BNF monograph and interaction data - not medical advice.
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Sourcing - Kenya onlyRegistration & product details
Source: Rwanda Food and Drugs Authority · fetched 2026-03-11 22:07:18 · updated 2026-09-17 02:30:43
Drug Interactions
215Pharmacodynamic Warnings
Clarithromycin appears in TABLE 9: Drugs that prolong the QT interval
Severe (35)
Acalabrutinib - increases exposure
Clarithromycin is predicted to increase the exposure to acalabrutinib. Avoid.
Alprazolam - increases exposure
Clarithromycin moderately increases the exposure to benzodiazepines (alprazolam). Avoid.
Antihistamines,non-Sedating - increases exposure
Clarithromycin is predicted to increase the exposure to antihistamines, non-sedating (mizolastine). Avoid.
Avapritinib - increases exposure
Clarithromycin is predicted to increase the exposure to avapritinib. Avoid.
Benzodiazepines - increases exposure
Clarithromycin moderately increases the exposure to benzodiazepines (alprazolam). Avoid.
Moderate (52)
Alfentanil - increases exposure
Clarithromycin is predicted to increase the exposure to opioids (alfentanil, buprenorphine, fentanyl, oxycodone). Monitor and adjust dose.
Aminophylline - increases exposure
Clarithromycin is predicted to increase the exposure to aminophylline. Adjust dose.
Amlodipine - increases exposure
Clarithromycin is predicted to increase the exposure to calcium channel blockers (amlodipine, felodipine, lacidipine, nicardipine, nifedipine, nimodipine). Monitor and adjust dose.
Antiarrhythmics - increases exposure
Clarithromycin is predicted to increase the exposure to antiarrhythmics (propafenone). Monitor and adjust dose.
Anticholinesterases, Centrally Acting - increases exposure
Clarithromycin is predicted to increase the exposure to anticholinesterases, centrally acting (galantamine). Monitor and adjust dose.
Unknown (128)
Abemaciclib - increases exposure
Clarithromycin is predicted to increase the exposure to abemaciclib. Avoid or adjust abemaciclib dose, p. 1056.
Afatinib - increases exposure
Macrolides are predicted to increase the exposure to afatinib.
Alitretinoin - increases exposure
Clarithromycin is predicted to increase the exposure to retinoids (alitretinoin). Adjust alitretinoin dose, p. 1382.
Almotriptan - increases exposure
Clarithromycin increases the exposure to triptans (almotriptan).
Alphablockers - increases exposure
Clarithromycin is predicted to increase the exposure to alpha blockers (doxazosin).
Data from BNF 85 (British National Formulary). This is not a substitute for professional medical advice. Matched via: exact
About clarithromycin
Clarithromycin is an antibiotic used to treat infections caused by bacteria.
What it treats
- bacterial infections
- chest infections (pneumonia)
- skin infections
- ear infections (otitis media)
How it works
It works by stopping the growth of bacteria, helping your body to fight off the infection.
Who it's for
It is for adults and children with certain bacterial infections.
Drug class
Macrolides
Cautions
- • Be cautious if you are taking other medications that affect heart rhythm.
AI-assisted summary grounded in BNF data - general information only, not medical advice. Always confirm with your pharmacist or doctor.
About omeprazole
Omeprazole is a medication that reduces stomach acid. It helps relieve symptoms associated with acid-related conditions.
What it treats
- stomach ulcers
- gastroesophageal reflux disease (GERD)
- excessive stomach acid
How it works
Omeprazole works by blocking the production of stomach acid, which helps heal ulcers and reduce heartburn.
Who it's for
Omeprazole is for adults and children over a certain age who have problems with too much stomach acid.
AI-assisted summary grounded in BNF data - general information only, not medical advice. Always confirm with your pharmacist or doctor.
About tinidazole
Tinidazole is an antibiotic used to treat infections caused by certain parasites and bacteria.
What it treats
- trichomoniasis (a sexually transmitted infection)
- giardiasis (a type of intestinal infection)
- amoebiasis (an infection caused by amoeba)
How it works
Tinidazole works by killing the harmful bacteria and parasites that cause infections.
Who it's for
Tinidazole is for adults and children who have specific types of infections.
AI-assisted summary grounded in BNF data - general information only, not medical advice. Always confirm with your pharmacist or doctor.
Clinical monograph: Tinidazole
BNF-referencedTinidazole is a synthetic antimicrobial drug with high efficacy against anaerobic bacteria and protozoa. It is primarily used to treat infections caused by Trichomonas vaginalis, Giardia duodenalis, and Entamoeba histolytica. Tinidazole has a longer duration of action compared to metronidazole, making it a suitable option for various infections.
Indications
- Intestinal amoebiasis
- Urogenital trichomoniasis
- Giardiasis
Dosage
Children: For children aged 1 month to 11 years, the dosage is 50–75 mg/kg once, with a maximum of 2 g per dose. For children aged 12 to 17 years, the dosage is 2 g for a single dose, which may be repeated once if necessary.
Adults: The usual adult dosage is 2 g taken orally as a single dose for urogenital trichomoniasis or giardiasis, and 1.5 g to 2 g once daily for 3 to 6 days for intestinal amoebiasis.
Mechanism of action
Tinidazole acts as a prodrug and antiprotozoal agent. Its nitro group is reduced in Trichomonas by a ferredoxin-mediated electron transport system, generating free nitro radicals that covalently bind to DNA, causing DNA damage and cell death. The exact mechanism of action against Giardia and Entamoeba species is not fully understood but is believed to be similar to that of Trichomonas.
Pharmacodynamics
Tinidazole demonstrates in vitro and clinical activity against Trichomonas vaginalis, Giardia duodenalis (also known as G. lamblia), and Entamoeba histolytica. It does not exhibit significant activity against most strains of vaginal lactobacilli, which are beneficial bacteria in the vaginal flora.
Pharmacokinetics
Tinidazole is well absorbed following oral administration, with peak plasma concentrations occurring within 0.5 to 3 hours. It is extensively distributed throughout body tissues and fluids. The drug undergoes hepatic metabolism and is eliminated primarily through the urine, with a half-life of approximately 12 to 14 hours. Clinical and laboratory monitoring is advised if treatment extends beyond 10 days.
Adverse effects
- Abdominal pain
- Decreased appetite
- Diarrhoea
- Headache
- Nausea
- Skin reactions
- Vertigo
- Vomiting
Precautions
- Clinical and laboratory monitoring is advised if treatment exceeds 10 days
Pregnancy
Manufacturer advises avoiding use in the first trimester.
Breast-feeding
Present in milk; the manufacturer advises avoiding breastfeeding during and for 3 days after stopping treatment.
Storage
Store below 25°C, protect from moisture.
Formulations
- Tinidazole 500 mg tablets
- Tinidazole oral suspension
AI-synthesized from BNF references - general information only, not a substitute for professional medical advice or the current BNF. Verify doses with a pharmacist.
Clinical monograph: Omeprazole
BNF-referencedOmeprazole is a proton pump inhibitor (PPI) that reduces gastric acid secretion by inhibiting the H+/K+ ATPase enzyme system at the secretory surface of the gastric parietal cells. It is primarily used for the treatment of conditions associated with excessive gastric acid production, such as peptic ulcers and gastro-oesophageal reflux disease (GERD).
Indications
- Gastric ulcer
- Duodenal ulcer
- Gastro-oesophageal reflux disease (GERD)
- Severe oesophagitis
- Helicobacter pylori eradication (in combination therapy)
- Prevention of NSAID-associated gastric and duodenal ulcers
- Zollinger-Ellison syndrome
Dosage
Adults: The usual dose for adults is 20 mg once daily for 4 weeks for duodenal ulcer and GERD. For gastric ulcer, the dose may be 20 mg to 40 mg once daily
Mechanism of action
Omeprazole works by specifically binding to the proton pump (H+/K+ ATPase) in the gastric parietal cells, leading to irreversible inhibition of acid secretion. This binding prevents the exchange of hydrogen ions for potassium ions, effectively reducing the production of gastric acid and promoting healing of acid-related conditions.
Pharmacodynamics
The pharmacodynamic effects of omeprazole manifest as a significant decrease in gastric acidity, which improves symptoms related to excessive acid secretion. The onset of action typically occurs within an hour of administration, with maximum effect seen within 2 to 4 days of continuous use. The duration of action allows for once-daily dosing in most indications.
Pharmacokinetics
Omeprazole is rapidly absorbed from the gastrointestinal tract, reaching peak plasma concentrations within 0.5 to 3.5 hours after oral administration. It is extensively metabolized in the liver via the cytochrome P450 system, primarily CYP2C19 and CYP3A4, leading to the formation of inactive metabolites. The elimination half-life is approximately 0.5 to 1 hour, but the effects on gastric acid secretion last much longer due to the irreversible nature of proton pump inhibition. Omeprazole is excreted mainly in the urine as metabolites, with less than 1% of the drug excreted unchanged.
Contra-indications
- Hypersensitivity to omeprazole or any component of the formulation
- Use with caution in patients with severe liver impairment
Adverse effects
- Nausea
- Vomiting
- Diarrhea
- Headache
- Abdominal pain
- Flatulence
- Constipation
- Dizziness
- Fatigue
- Rash
- Muscle weakness
- Gastrointestinal candidiasis
- Aggression
- Agitation
- Bronchospasm
- Encephalopathy
Interactions
- Cenobamate may increase exposure to omeprazole
- Fedratinib may increase exposure to omeprazole
- Apalutamide may decrease exposure to omeprazole
- Cilostazol may increase exposure to omeprazole
Precautions
- Monitor patients for gastrointestinal symptoms
- Use caution in patients with a history of liver disease
- Consider potential for vitamin B12 deficiency with long-term use
- Monitor for signs of Clostridium difficile infection in the colon
Pregnancy
Not known to be harmful during pregnancy, but should be used only if clearly needed.
Breast-feeding
Excreted in breast milk, caution is advised when administered to nursing mothers.
Storage
Store below 25 degrees Celsius. Protect from moisture. Keep out of reach of children.
Formulations
- Orodispersible tablets
- Gastro-resistant capsules
- Intravenous injection
- Oral suspension
AI-synthesized from BNF references - general information only, not a substitute for professional medical advice or the current BNF. Verify doses with a pharmacist.
Clinical monograph: Clarithromycin
BNF-referencedClarithromycin is a macrolide antibiotic effective against a range of bacterial infections. It is primarily used in the treatment of community-acquired pneumonia, skin infections, and as a prophylactic measure for certain infections. Clarithromycin works by inhibiting bacterial protein synthesis, making it a crucial agent in combating gram-positive and some gram-negative bacteria.
Indications
- Bacterial infections
- Community-acquired pneumonia
- Skin infections
- Prophylaxis for certain infections
Dosage
Adults: 500 mg once daily for
Mechanism of action
Clarithromycin is metabolized to 14-OH clarithromycin, which is active. It penetrates bacterial cell walls and reversibly binds to domain V of the 23S ribosomal RNA of the 50S ribosomal subunit, blocking the translocation of aminoacyl-tRNA and inhibiting polypeptide synthesis. It may be bactericidal in high concentrations against susceptible organisms, particularly Streptococcus pyogenes, S. pneumoniae, Haemophilus influenzae, and Chlamydia trachomatis. Additionally, clarithromycin inhibits the hepatic microsomal CYP3A4 isoenzyme and P-glycoprotein.
Pharmacodynamics
Clarithromycin exhibits a broad spectrum of activity against numerous gram-positive bacteria, including Staphylococcus aureus, Streptococcus pneumoniae, and Streptococcus pyogenes. It also shows activity against gram-negative bacteria such as Haemophilus influenzae and Moraxella catarrhalis, as well as against various anaerobic bacteria, mycobacteria, and other organisms like Mycoplasma, Ureaplasma, and Chlamydia. While typically bacteriostatic, it can sometimes demonstrate bactericidal properties depending on the concentration and the organism.
Pharmacokinetics
Clarithromycin is well absorbed after oral administration, with its bioavailability enhanced by food. It is extensively metabolized in the liver, primarily via CYP3A4, leading to active metabolites. The drug has a half-life of approximately 3 to 4 hours, but its active metabolite, 14-OH clarithromycin, has a longer half-life, contributing to its prolonged activity. Renal impairment can significantly affect its clearance, necessitating dosage adjustments in patients with reduced renal function.
Adverse effects
- Nausea
- Diarrhea
- Abdominal pain
- Dysgeusia
- Headache
- Rash
- Liver enzyme elevations
- QT prolongation
Interactions
- Clarithromycin + acalabrutinib: Severe (increases exposure)
- Clarithromycin + antiarrhythmics: Severe (increases exposure)
- Clarithromycin + dronedarone: Severe (increases exposure)
- Clarithromycin + non-sedating antihistamines: Severe (increases exposure)
- Clarithromycin + mizolastine: Severe (increases exposure)
- Clarithromycin + lurasidone: Severe (increases exposure)
- Clarithromycin + quetiapine: Severe (increases exposure)
- Clarithromycin + avapritinib: Severe (increases exposure)
- Clarithromycin + benzodiazepines: Severe (increases exposure)
- Clarithromycin + alprazolam: Severe (increases exposure)
Precautions
- Caution in hepatic impairment
- Use with caution in renal impairment
- Monitor for signs of QT prolongation
- Consider alternative therapy in patients with history of arrhythmias
- Use with caution in patients with myasthenia gravis due to potential exacerbation
Pregnancy
Manufacturers advise use only if adequate alternatives are not available.
Breast-feeding
Present in milk; use only if no suitable alternatives.
Storage
Store in a cool, dry place away from light. Keep out of reach of children.
Formulations
- Oral suspension 200 mg/5 mL
- Capsules 250 mg
AI-synthesized from BNF references - general information only, not a substitute for professional medical advice or the current BNF. Verify doses with a pharmacist.
Molecular reference: Clarithromycin
PubChem CID 84029Molecular formula: C38H69NO13
Mechanism of action
Clarithromycin is first metabolized to 14-OH clarithromycin, which is active and works synergistically with its parent compound. Like other macrolides, it then penetrates bacteria cell wall and reversibly binds to domain V of the 23S ribosomal RNA of the 50S subunit of the bacterial ribosome, blocking translocation of aminoacyl transfer-RNA and polypeptide synthesis. Clarithromycin also inhibits the hepatic microsomal CYP3A4 isoenzyme and P-glycoprotein, an energy-dependent drug efflux pump. Clarithromycin usually is bacteriostatic, although it may be bactericidal in high concentrations or against highly susceptible organisms. Bactericidal activity has been observed against Streptococcus pyogenes, S. pneumoniae, Haemophilus influenzae, and Chlamydia trachomatis. Clarithromycin inhibits protein synthesis in susceptible organisms by penetrating the cell wall and binding to 50S ribosomal subunits, thereby inhibiting translocation of aminoacyl transfer-RNA and inhibiting polypeptide synthesis. The site of action of clarithromycin appears to be the same as that of erythromycin, clindamycin, lincomycin, and chloramphenicol.
Pharmacodynamics
Clarithromycin is a macrolide antibiotic whose spectrum of activity includes many gram-positive (<i>Staphylococcus aureus, S. pneumoniae, and S. pyogenes</i>) and gram-negative aerobic bacteria (<i>Haemophilus influenzae, H. parainfluenzae, and Moraxella catarrhalis</i>), many anaerobic bacteria, some mycobacteria, and some other organisms including <i>Mycoplasma, Ureaplasma, Chlamydia, Toxoplasma</i>, and <i>Borrelia</i>. Other aerobic bacteria that clarithromycin has activity against include <i>C. pneumoniae and M. pneumoniae</i>. Clarithromycin has an in-vitro activity that is similar or greater than that of erythromycin against erythromycin-susceptible organisms. Clarithromycin is usually bacteriostatic, but may be bactericidal depending on the organism and the drug concentration.
Biological pathways
Source: PubChem (NCBI) · pathways from PathBank, Reactome, WikiPathways & PharmGKB.
Molecular reference: Omeprazole
PubChem CID 4594Molecular formula: C17H19N3O3S
Biological pathways
Source: PubChem (NCBI) · pathways from PathBank, Reactome, WikiPathways & PharmGKB.
Molecular reference: Tinidazole
PubChem CID 5479Molecular formula: C8H13N3O4S
Mechanism of action
Tinidazole is a prodrug and antiprotozoal agent. The nitro group of tinidazole is reduced in <i>Trichomonas</i> by a ferredoxin-mediated electron transport system. The free nitro radical generated as a result of this reduction is believed to be responsible for the antiprotozoal activity. It is suggested that the toxic free radicals covalently bind to DNA, causing DNA damage and leading to cell death. The mechanism by which tinidazole exhibits activity against <i>Giardia</i> and <i>Entamoeba</i> species is not known, though it is probably similar. The nitro group of tinidazole is reduced by cell extracts of Trichomonas. As a result of this reduction a free nitro radical is generated which may be responsible for the antiprotozoal activity. The mechanism by which tinidazole exhibits activity against Giardia and Entamoeba species is not known.
Pharmacodynamics
Tinidazole is a synthetic antiprotozoal agent. Tinidazole demonstrates activity both in vitro and in clinical infections against the following protozoa: <i>Trichomonas vaginalis</i>, <i>Giardia duodenalis</i> (also termed <i>G. lamblia</i>), and <i>Entamoeba histolytica</i>. Tinidazole does not appear to have activity against most strains of vaginal lactobacilli.
Source: PubChem (NCBI) · pathways from PathBank, Reactome, WikiPathways & PharmGKB.
This drug in other countries
The same active ingredient registered across other registries we cover - including different brands.
- ACIDOM CAPSULES (Each capsule contains Omeprazole 20mg) · S.Kant Healthcare
- ACIDOM INJECTION 40mg · Reyoung Pharmaceuticals
- AVENTRA CAPSULES (Each capsule contains Omeprazole Sodium 20mg) · Centurion Laboratories
- CAPSULES (Each capsule contains Omeprazole 20mg) · Navketan Pharma
- CAREOMEZ INJECTION · Reyoung Pharmaceuticals
- CAREOMEZ INJECTION · Reyoung Pharmaceutical