Klacid/Klacid MR Dosage/Direction for Use

Adults: Klacid tab: The usual recommended dosage of clarithromycin in adults and children 12 years of age or older, is one 250 mg tablet twice daily. In more severe infections, the dosage can be increased to 500 mg twice daily. The usual duration of therapy is 5 to 14 days, excluding treatment of community acquired pneumonia and sinusitis which require 6 to 14 days of therapy.
Klacid MR: The usual recommended dosage of clarithromycin MR tablets in adults and children 12 years of age or older is 500 mg once-daily with food. In more severe infections, the dosage may be increased to 1,000 mg-once daily (2 x 500 mg). The usual duration of therapy is 5-14 days, excluding treatment of community acquired pneumonia and sinusitis which require 6 to 14 days therapy.
Klacid Ped oral susp: Pediatric patients under 12 years of age: Clinical trials have been conducted using clarithromycin pediatric suspension in children 6 months to 12 years of age. Therefore, children under 12 years of age should use clarithromycin pediatric suspension (granules for oral suspension).
The recommended daily dosage of clarithromycin pediatric suspension (125 mg/5 ml) in children is 7.5 mg/kg b.i.d. up to a maximum dose of 500 mg b.i.d. for non-mycobacterial infections. The usual duration of treatment is for 5 to 10 days depending on the pathogen involved and the severity of the condition. The prepared suspension can be taken with or without meals, and can be taken with milk.
The following table is a suggested guide for determining dosage: See Table 2.

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Dosage in Patients with Mycobacterial Infections: Klacid tab & Klacid MR: The recommended dose for adults with mycobacterial infections is 500 mg b.i.d.
Treatment of disseminated MAC infections in AIDS patients should be continued, as long as clinical and microbiological benefit is demonstrated. Clarithromycin should be used in conjunction with other antimycobacterial agents.
Treatment of other nontuberculous mycobacterial infections should continue at the discretion of the physician.
Klacid Ped oral susp: In children with disseminated or localized mycobacterial infections (M. avium, M. intracellulare, M. chelonae, M. fortuitum, M. kansasii), the recommended dose is 7.5 to 15 mg/kg clarithromycin twice daily, not exceeding a maximum dose of 500 mg twice daily.
Treatment with clarithromycin should continue as long as clinical benefit is demonstrated. The addition of other antimycobacterial agents may be of benefit. (See Table 3.)

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Dosage for MAC prophylaxis: Klacid tab & Klacid MR: The recommended dosage of clarithromycin in adults is 500 mg twice daily.
In the treatment of odontogenic infections, the dosage of clarithromycin is one 250 mg tablet twice daily for five days.
In patients with peptic ulcer due to H. pylori infection, clarithromycin can be administered in a dose of 500 mg twice daily in combination with other appropriate anti-microbial treatments and a proton pump inhibitor for 7-14 days in consultation with national or international guideline recommendations for H. pylori eradication.
Renal Impairment: Klacid tab: In patients with renal impairment with creatinine clearance less than 30 mL/min, the dosage of clarithromycin should be reduced by one-half, i.e., 250 mg once daily, or 250 mg twice daily in more severe infections. Treatment should not be continued beyond 14 days in these patients.
Klacid MR: Clarithromycin modified release should not be used in patients with significant renal impairment (creatinine clearance less than 30 mL/min), as appropriate clarithromycin dosage reduction is not possible when administering this product. Clarithromycin immediate release tablets may be utilized in this patient population (see Contraindications). For patients with moderate renal function (creatinine clearance 30 to 60 mL/min), a 50% dosage reduction should be implemented resulting in a maximum dose of one clarithromycin modified release tablet per day.
Klacid Ped oral susp: In children with creatinine clearance less than 30 mL/min/1.73 m2, the dosage of clarithromycin should be reduced by one-half, i.e., up to 250 mg once daily, or 250 mg twice daily in more severe infections. Dosage should not be continued beyond 14 days in these patients.
Pediatric: Klacid tab & Klacid MR: The use of clarithromycin IR/MR has not been studied in children less than 12 years of age.
Preparation for use: An appropriate amount of water, consult the approved International Manufacturing Formula, should be added to the granules in the bottle and shaken until all of the particles are suspended. Avoid vigorous and/or lengthy shaking. Shake prior to each subsequent use to ensure resuspension. The concentration of clarithromycin in the reconstituted suspension is 125 mg/5 ml.
Administration: Klacid MR: Do not crush or chew clarithromycin modified release tablets.
Klacid Ped oral susp: Several devices can be used to dose and administer clarithromycin pediatric suspension.
Conservation: After reconstitution, store at room temperature (15°C to 30°C) and use within 14 days. Do not refrigerate.