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Common brand name: Biaxin

Description: Clarithromycin is a macrolide antibiotic. It is related to erythromycin.

Dental uses: The main dental use of clarithromycin is in people who are allergic to penicillins and at risk to develop bacterial endocarditis. This is a serious heart infection. It can be fatal. People at risk for this bacterial infection take antibiotics before dental procedures that tend to cause bleeding. People at risk include those who have:

  • Artificial heart valves
  • A history of endocarditis
  • Certain forms of congenital heart disease
  • A transplanted heart that develops valve disease

Bleeding can occur in procedures that:

  • Puncture or cut into mouth tissue
  • Manipulate the gums or the area around a tooth root

People who have a high risk of bacterial endocarditis usually take amoxicillin before these procedures. Clarithromycin is used for those who are allergic to amoxicillin and other relatives of penicillin.

Clarithromycin is also used in patients with penicillin allergies who have dental infections. These may include abscesses, infections around wisdom teeth and infections after dental surgery. This drug can also be used when other drugs have not been effective.

Dosages for dental purposes: To prevent bacterial endocarditis, the recommended dose is 500 milligrams. It should be taken 30 to 60 minutes before the dental procedure. For dental infections, the typical dose is 250 milligrams to 500 milligrams. Clarithromycin should be taken every 12 hours for 7 to 10 days.

As with all medicines, be sure to follow your doctor's prescription. Take clarithromycin for the prescribed length of time, even if you start to feel better. Do not stop taking it without talking to your doctor. Stopping an antibiotic too soon may cause bacteria to become resistant to antibiotics. This means the antibiotics won't work the next time.

Concerns and possible side effects: Tell your dentist and physician about all the medicines you take. This should include over-the-counter vitamins and herbal supplements. Also, let your dentist know if you have had a sensitive or allergic reaction to any medicine. If you are pregnant or nursing, or might be pregnant, talk to your primary care doctor before starting any new medicine. This also includes vitamins and supplements.

Clarithromycin costs more than erythromycin. However, it is less likely to cause abdominal pain, nausea, vomiting or diarrhea. People who take it occasionally get a strange taste in their mouths.

People who take clarithromycin have a small risk of developing a serious heart condition (torsade de pointes). This risk increases by an unknown amount when a dentist gives an injection of local anesthesia that contains epinephrine or levonordefrin. These local anesthetics should be used with caution in people taking clarithromycin. The U.S. Food and Drug Administration also warned of another risk in 2005. It found that death rates are higher in people with stable coronary artery disease who use clarithromycin for 14 days or more.

Clarithromycin can have bad interactions with several different drugs. For example, it can cause certain other drugs to build up in the body. These drugs include:

  • The asthma drug theophylline (brand name, Theo-Dur)
  • The blood-thinner warfarin (brand name, Coumadin)
  • The "statin" cholesterol-lowering drugs such as lovastatin (brand name, Mevacor), simvastatin (brand name, Zocor) and atorvastatin (brand name, Lipitor)
  • The headache medicine ergotamine and caffeine (brand names Cafergot, Wigraine)

This list is not complete, and it continues to grow. These interactions can be serious and life threatening. Tell your doctor about any reaction to a prescribed medicine, no matter how minor it might be.

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