CLARITHROMYCIN TECNIGEN 250 mg FILM-COATED TABLETS

2. Before taking CLARITHROMYCIN TECNIGEN 250 mg film-coated tablets

Do not take Clarithromycin TECNIGEN:

• If you are allergic (hypersensitive) to clarithromycin or any of the other components of this medicine.
• If you are allergic to macrolide antibiotics.
• If you are taking other medicines such as cisapride (for gastrointestinal problems), pimozide (for psychiatric disorders), terfenadine or astemizole (for allergies), disopyramide, and quinidine (for heart disorders). If you take these medicines with clarithromycin, you may have serious heart problems (see "Using other medicines").

If you take these medicines with clarithromycin, you may have serious heart problems (see "Using other medicines").

• If you are taking ergotamine or dihydroergotamine (for migraines).
• If you are taking a medicine with lomitapide.
• If you have abnormally low levels of potassium or magnesium in your blood (hypokalemia or hypomagnesemia).
• if you are taking ticagrelor, ivabradine, or ranolazine (for angina pectoris or to reduce the risk of myocardial infarction or stroke).

Be careful with Clarithromycin TECNIGEN:

• If you have any liver disease.
• If you have kidney disease (moderate to severe renal insufficiency).
• If you are elderly.
• If you are taking colchicine, as toxicity may occur.
• If you have taken other macrolide antibiotics or lincomycin and clindamycin antibiotics and the infection has not been resolved as a result of being caused by a resistant germ, or you have not been able to use these antibiotics for this reason. There is a possibility that clarithromycin may not be effective and the infection may not be cured because the causative germ of your infection is also resistant to clarithromycin. Consult your doctor about any questions you may have.
• If you are being treated for an infection caused by Mycobacterium avium (which usually occurs in AIDS patients or manifests as a pulmonary disease) because you should have an audiometry before starting treatment and your hearing ability should be monitored during treatment. It is also recommended that you have periodic monitoring of your white blood cell and platelet count. Additionally, if you are taking rifabutin (another antibiotic) in the treatment of these infections, you should know that the risk of uveitis (an eye disorder) increases, so you should have adequate monitoring.
• If you experience diarrhea because treatment with clarithromycin, like most antibiotics, can cause pseudomembranous colitis (inflammation of the large intestine that causes diarrhea and abdominal pain) due to the microorganism Clostridium difficile, and your doctor should rule out this diagnosis.
• If you are taking lovastatin or simvastatin to lower your cholesterol levels, because taking them with clarithromycin may increase the risk of rhabdomyolysis (a muscle disorder).
• If you are taking oral anticoagulants because it is recommended that your prothrombin time be monitored.

Using other medicines

Tell your doctor or pharmacist if you are using or have recently used other medicines, including those obtained without a prescription.

• The following medicines should not be taken with clarithromycin TECNIGEN: astemizole and terfenadine (for allergies), cisapride (for gastrointestinal problems), disopyramide and quinidine (for heart disorders), and pimozide (for psychiatric disorders), as these medicines may increase the risk of serious heart problems when administered with clarithromycin.
• You should not use ergotamine or dihydroergotamine because if you take them with clarithromycin, you may experience ergotism (acute toxicity caused by ergot-derived drugs) characterized by vasospasm (contraction of the walls of the arteries that makes it difficult for blood to pass through them) and ischemia (lack of oxygen) of the extremities and other tissues, including the central nervous system.

The following medicines should be taken with caution during treatment with clarithromycin and you should consult your doctor before taking them, as it may be necessary to reduce the dose and monitor you closely:

• Oral anticoagulants (warfarin or other anticoagulants, such as dabigatran, rivaroxaban, apixaban, edoxaban). The risk of bleeding may increase.
• Medicines that lower cholesterol levels, such as lovastatin and simvastatin.

The risk of rhabdomyolysis (muscle disorder) increases.

• Antiepileptics, for epilepsy: phenytoin, carbamazepine, valproate.
• Certain immunosuppressants, which reduce the body's defense against foreign substances and are used, for example, in organ transplantation: cyclosporine, tacrolimus, and rapamycin.
• Certain anticancer agents, such as vinca alkaloids: vinblastine.
• Benzodiazepines, for anxiety and insomnia: alprazolam, midazolam, triazolam.
• Antifungals, for fungal infections: fluconazole, itraconazole, ketoconazole.
• Antiretrovirals, for HIV infection: zidovudine.

Concomitant treatment with clarithromycin and zidovudine may result in a decrease in zidovudine blood levels due to clarithromycin interfering with zidovudine's oral absorption. Therefore, it is recommended to space out the administration of both medicines.

• Others: digoxin (for the heart), theophylline (for asthma), rifabutin (antibiotic), sildenafil (for erectile dysfunction), methylprednisolone (corticosteroid), cilostazol (anticoagulant), and in general, those medicines that have a similar metabolism.
• There have been reports of colchicine toxicity when taken with clarithromycin, especially in the elderly, some of whom had kidney problems.
• Hydroxychloroquine or chloroquine (used to treat diseases such as rheumatoid arthritis or to treat or prevent malaria). Taking these medicines at the same time as clarithromycin may increase the risk of abnormal heart rhythms and other serious adverse reactions that affect the heart.
• Corticosteroids, administered orally, by injection, or inhaled (used to suppress the immune system; this is useful in the treatment of a wide range of diseases)

The following medicines increase the amount of clarithromycin absorbed from the administered dose, so you should consult your doctor before taking them:

• Omeprazole (for digestive disorders such as ulcers and gastroesophageal reflux). Concomitant administration of clarithromycin and omeprazole increases the blood levels of both medicines.
• Ritonavir (for HIV infection). Concomitant administration of ritonavir and clarithromycin results in a significant reduction in clarithromycin elimination, so it remains unchanged in the body for a longer time, although due to clarithromycin's wide therapeutic margin, a dose adjustment should not be necessary if you have normal kidney function. However, if you have kidney disease (creatinine clearance between 30-60 ml/min and <30 ml min), your doctor should adjust the clarithromycin dose by 50% and 75%, respectively.< li>
• In post-marketing, interactions have been observed between the following medicines, which have a similar metabolism to erythromycin or clarithromycin: astemizole, cisapride, disopyramide, ergotamine, dihydroergotamine, lovastatin, pimozide, quinidine, simvastatin, and terfenadine.
• Clarithromycin may negatively affect the efficacy of antibiotics known as "beta-lactams" to which penicillins (amoxicillin, ampicillin, etc.) and cephalosporins (cefuroxime, cefaclor, etc.) belong, as well as the effects of lincomycin and clindamycin antibiotics.

Clarithromycin TECNIGEN may affect the efficacy of the following medicines: digoxin, theophylline.

Taking Clarithromycin TECNIGEN with food and drinks

Clarithromycin TECNIGEN tablets can be taken before, during, or after meals, as the presence of food in the digestive tract does not alter the activity of the medicine.

Pregnancy and breastfeeding

• The safety of clarithromycin during pregnancy has not been established. If you are pregnant or think you may be pregnant, do not take Clarithromycin TECNIGEN without consulting your doctor first, and he will decide whether you should take it or not.
• The safety of clarithromycin during breastfeeding has not been established. Clarithromycin is excreted in breast milk. If you are breastfeeding, do not take this medicine.
• Consult your doctor or pharmacist before using any medicine.

Driving and using machines

No effects on the ability to drive vehicles and use machinery are known.

Clarithromycin TecniGen contains propylene glycol

This medicine contains 1.305 mg of propylene glycol in each tablet.

Clarithromycin TecniGen contains sodium

This medicine contains less than 23 mg of sodium (1mmol) per tablet; this is, essentially "sodium-free".

3. How to take CLARITHROMYCIN TECNIGEN 250 mg film-coated tablets

Clarithromycin TECNIGEN is administered orally.

Follow your doctor's instructions for taking Clarithromycin TECNIGEN exactly. Consult your doctor or pharmacist if you have any doubts.

Adults: in patients with peptic ulcer associated with Helicobacter pylori, the recommended treatments are:

Triple therapy: 500 mg of clarithromycin, twice a day, with 1000 mg of amoxicillin twice a day and 20 mg of omeprazole once a day, for 10 days, or 500 mg of clarithromycin, with 1000 mg of amoxicillin and 20 mg of omeprazole, all administered twice a day, for 7 days. Dual therapy: 500 mg of clarithromycin, three times a day, with 40 mg of omeprazole, once a day, for 2 weeks. To ensure healing in patients with duodenal ulcer with poor therapeutic response, treatment with 40 mg of omeprazole may be extended up to 4 weeks.

The average recommended dose for the prevention and treatment of mycobacterial infections is 500 mg of clarithromycin, every 12 hours. The duration of treatment should be determined by your doctor.

In the treatment of respiratory tract, skin, and soft tissue infections, the duration of treatment should be determined by your doctor and depends on the severity and type of infection. It ranges from 6 to 14 days. The patient should strictly follow the doctor's instructions, even if the discomfort disappears. The usual recommended dose for adults is one Clarithromycin TECNIGEN tablet 2 times a day. In more severe infections, the dose may be increased to 500 mg, 2 times a day.

Remember to take your medicine. Take the tablets at the same time every day.

Your doctor will indicate the duration of your treatment. Do not stop treatment before, as your disease may worsen or reappear.

If you feel that the effect of Clarithromycin TECNIGEN is too strong or too weak, consult your doctor or pharmacist.

If you take more Clarithromycin TECNIGEN than you should

If you have taken more Clarithromycin TECNIGEN than you should, you can expect the appearance of digestive disorders, and consult your doctor or pharmacist immediately, as they will try to quickly eliminate the clarithromycin that your body has not yet absorbed. Hemodialysis or peritoneal dialysis is not effective.

In case of overdose or accidental ingestion, consult the Toxicology Information Service, phone 91.562.04.20, indicating the medicine and the amount ingested.

If you forget to take Clarithromycin TECNIGEN

Do not take a double dose to make up for forgotten doses. Take the tablet as soon as possible and continue taking it every day at the same time.

If you stop taking Clarithromycin TECNIGEN

If you have any other questions about the use of this product, ask your doctor or pharmacist.

4. Possible side effects

Like all medicines, Clarithromycin TECNIGEN can cause side effects, although not everybody gets them.

Side effects can be classified as very common (at least 1 in 10 patients), common (at least 1 in 100 patients), uncommon (at least 1 in 1,000 patients), rare (at least 1 in 10,000 patients), and very rare (less than 1 in 10,000 patients).

The most common side effects (at least 1 in 100 patients) are related to the digestive system, such as nausea, diarrhea, and vomiting. Other adverse reactions include headaches, taste disturbances, hearing loss (usually reversible with treatment discontinuation), tinnitus, and mild skin rashes.

Less common side effects (at least 1 in 1,000 patients) include decreased white blood cell or platelet count in the blood, liver alterations (which are generally reversible), alterations in liver function tests, allergic reactions that can range from itching to, in rare cases, severe allergies, transient central nervous system effects (dizziness, anxiety, insomnia, nightmares, confusion, hallucinations, and convulsions, although a cause-and-effect relationship has not been established), altered sense of smell usually accompanied by altered sense of taste, gum inflammation, superficial inflammation of the tongue, tongue discoloration, as well as tooth discoloration (this discoloration usually disappears with a professional dental cleaning), pancreatitis, abdominal pain, and gastrointestinal discomfort or indigestion.

Rarely (at least 1 in 10,000 patients), low blood sugar levels have been described, in some cases associated with the use of diabetes medications.

Very rarely (at least 1 in 10,000 patients), elevated blood creatinine levels or generalized allergic reactions have been observed.

Very rarely (at least 1 in 10,000 patients), disorientation, psychosis, or depersonalization have been described (although a cause-and-effect relationship has not been established).

Rarely (at least 1 in 10,000 patients), alterations in the electrocardiogram or heart rhythm have been described.

It is also rare (at least 1 in 10,000 patients) to experience vertigo, oral fungal infections, or liver damage (which can be fatal in rare cases and is usually associated with the patient having another serious disease and receiving other medication).

Isolated cases (frequency cannot be determined with available data) of interstitial nephritis (kidney disorder caused by inflammation of parts of the kidney) have been observed.

There have been reports of colchicine toxicity when taken with clarithromycin (some of which had a fatal outcome, mainly in elderly patients with kidney problems).

Contact a doctor as soon as possible if you experience a severe skin reaction: a red and scaly rash with bumps under the skin and blisters (pustular exanthematous eruption). The frequency of this side effect is considered unknown (cannot be estimated from available data).

If you experience any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet.

5. Storing CLARITHROMYCIN TECNIGEN 250 mg film-coated tablets

Keep out of the reach and sight of children.

This medicine does not require special storage conditions.

Do not use Clarithromycin TECNIGEN after the expiration date stated on the packaging after EXP. The expiration date is the last day of the month indicated.

Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of the packaging and medicines you no longer need. This will help protect the environment.

6. FURTHER INFORMATION

Composition of Clarithromycin Tecnigen 250 mg tablets

The active ingredient is clarithromycin. Each tablet contains 250 mg of clarithromycin.

The other components (excipients) are: pregelatinized corn starch, sodium croscarmellose, povidone, microcrystalline cellulose, anhydrous colloidal silica, magnesium stearate, hypromellose, titanium dioxide, talc, propylene glycol.

Appearance of the product and packaging content

Clarithromycin Tecnigen 250 mg tablets are round, biconvex, white or almost white, coated.

The tablets are presented in PVC/PVDC blisters attached to an aluminum foil. This medication is presented in packages of 12 or 500 tablets.

Marketing authorization holder and manufacturer Responsible:

TECNIMEDE ESPAÑA INDUSTRIA FARMACEUTICA, S.A.

Avda. de Bruselas, 13, 3º D.Edificio América. Polígono Arroyo de la Vega,

28108 Alcobendas (Madrid), Spain

Manufacturer:

BLUEPHARMA – Indústria Farmacêutica, S.A.

• Martinho do Bispo. 3045-016 Coimbra

Portugal

This leaflet was revised in March 2024.