Kruklar
Kruklar Uses, Dosage, Side Effects, Food Interaction and all others data.
Kruklar is a macrolide antibiotic. It acts by inhibiting microsomal protein synthesis by binding to the 50S subunit of the bacterial ribosome. Kruklar is active against most gram-positive bacteria, Chlamydia, some gram-negative bacteria and Mycoplasmas.
Kruklar is a macrolide antibiotic whose spectrum of activity includes many gram-positive (Staphylococcus aureus, S. pneumoniae, and S. pyogenes) and gram-negative aerobic bacteria (Haemophilus influenzae, H. parainfluenzae, and Moraxella catarrhalis), many anaerobic bacteria, some mycobacteria, and some other organisms including Mycoplasma, Ureaplasma, Chlamydia, Toxoplasma, and Borrelia. Other aerobic bacteria that clarithromycin has activity against include C. pneumoniae and M. pneumoniae. Kruklar has an in-vitro activity that is similar or greater than that of erythromycin against erythromycin-susceptible organisms. Kruklar is usually bacteriostatic, but may be bactericidal depending on the organism and the drug concentration.
Trade Name | Kruklar |
Availability | Prescription only |
Generic | Clarithromycin |
Clarithromycin Other Names | 6-O-methyl erythromycin, 6-O-methylerythromycin, 6-O-methylerythromycin A, Clarithromycin, Clarithromycina, Clarithromycine, Clarithromycinum, Claritromicina |
Related Drugs | amoxicillin, prednisone, omeprazole, pantoprazole, doxycycline, ciprofloxacin, cephalexin, metronidazole, azithromycin, clindamycin |
Type | |
Formula | C38H69NO13 |
Weight | Average: 747.9534 Monoisotopic: 747.476891299 |
Protein binding | ~ 70% protein bound |
Groups | Approved |
Therapeutic Class | Macrolides |
Manufacturer | |
Available Country | Italy |
Last Updated: | September 19, 2023 at 7:00 am |
Uses
- LRTIs for example, acute and chronic bronchitis and pneumonia.
- URTIs for example, sinusitis and pharyngitis.
- Community-acquired pneumonia, atypical pneumonia
- Skin and soft tissue infection
- Adjunct in the treatment of duodenal ulcers to eradicate of H. pylori
Kruklar is also used to associated treatment for these conditions: Acute Bacterial Exacerbation of Chronic Bronchitis (ABECB), Acute maxillary sinusitis, Bacterial Infections, Bartonellosis, Community Acquired Pneumonia (CAP), Duodenal ulcer caused by helicobacter pylori, Infective Endocarditis, Lyme Disease, Mycobacterial Infections, Otitis Media (OM), Pertussis, Streptococcal Pharyngitis, Streptococcal tonsillitis, Uncomplicated skin and subcutaneous tissue bacterial infections
How Kruklar works
Kruklar 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. Kruklar also inhibits the hepatic microsomal CYP3A4 isoenzyme and P-glycoprotein, an energy-dependent drug efflux pump.
Dosage
Kruklar dosage
Kruklar may be given with or without meals.
Adults (12 years or above):
250 mg twice daily for 7 days. Dose may be increased to 500 mg twice daily for up to 14 days in pneumonia or severe infections.
Combination therapy for H. pylori infection:
Kruklar 500 mg (two 250 mg tablets or one 500 mg tablet) twice daily in combination with Amoxicillin 1000 mg twice daily and Omeprazole 20 mg twice daily should be continued for 10 days.
Children:
The usual recommended daily dosage is 15 mg/kg in 2 divided doses for 10 days.
Approximate Calculation of dose:
1. For 9kg body weight 2.5ml 12 hourly for 10 days
2. For 17kg body weight 5ml 12 hourly for 10 days
3. For 25kg body weight 7.5ml 12 hourly for 10 days
4. For 33kg body weight 10ml 12 hourly for 10 days
Direction for reconstitution of suspension:
Shake the bottle to loosen granules. Add 35 ml of boiled and cooled water with the help of the supplied cup, to the dry granules of the bottle. For ease of preparation, add water to the bottle in two proportions. Shake well after each addition until all the granules is in suspension.
Note: Shake the suspension well before each use. Keep the bottle tightly closed. The reconstituted suspension should be stored in a cool and dry place, preferably in refrigerator.
This may be given with or without meals.
The usual duration of treatment is 6 to 14 days.
Children older than 12 years: As for adults.
Eradication of H. pylori in patients with duodenal ulcers: Adults: The usual duration of treatment is 6 to 14 days.
45 ml of water is to be added to the granules in the bottle and shaken to yield 70 ml of reconstituted suspension. The concentration of clarithromycin in the reconstituted suspension is 125 mg per 5 ml.
Side Effects
The most frequently reported events in adults taking Kruklar were diarrhoea (3%), nausea (3%), abnormal taste (3%), dyspepsia (2%), abdominal pain/discomfort (2%), headache (2%) and oral monilia.
Toxicity
Symptoms of toxicity include diarrhea, nausea, abnormal taste, dyspepsia, and abdominal discomfort. Transient hearing loss with high doses has been observed. Pseudomembraneous colitis has been reported with clarithromycin use. Allergic reactions ranging from urticaria and mild skin eruptions to rare cases of anaphylaxis and Stevens-Johnson syndrome have also occurred. Rare cases of severe hepatic dysfunctions also have been reported. Hepatic failure is usually reversible, but fatalities have been reported. Kruklar may also cause tooth decolouration which may be removed by dental cleaning. Fetal abnormalities, such as cardiovascular defects, cleft palate and fetal growth retardation, have been observed in animals. Kruklar may cause QT prolongation.
Precaution
Caution should be taken in administering this antibiotic to patients with impaired hepatic and renal function. Prolonged or repeated use of Kruklar may result in an overgrowth of nonsusceptible bacteria or fungi. If superinfection occurs, Kruklar should be discontinued.
Pharmaceutical precaution
Kruklar tablet should be stored in a cool and dry place and away from sunlight.
Interaction
Concomitant use of Kruklar who are receiving Theophylline may be associated with an increase in serum Theophylline concentrations. Kruklar may alter the metabolism of Terfenadine. The effects of digoxin may be potentiated with concomitant administration of Kruklar. Kruklar resulted in decrease in serum levels of Rifabutin, followed by an increased risk of uveitis.
Food Interaction
- Take with food. Food increases absorption.
[Minor] Grapefruit juice may delay the gastrointestinal absorption of clarithromycin but does not appear to affect the overall extent of absorption or inhibit the metabolism of clarithromycin.
The mechanism of interaction is unknown but may be related to competition for intestinal CYP450 3A4 and In an open-label, randomized, crossover study consisting of 12 healthy subjects, coadministration with grapefruit juice increased the time to reach peak plasma concentration (Tmax) of both clarithromycin and 14-hydroxyclarithromycin (the active metabolite) by 80% and 104%, respectively, compared to water. Other pharmacokinetic parameters were not significantly altered. This interaction is unlikely to be of clinical significance.
Kruklar Drug Interaction
Moderate: albuterol / ipratropium, albuterol / ipratropiumMinor: amoxicillin / clavulanate, amoxicillin / clavulanate, esomeprazole, esomeprazoleUnknown: diphenhydramine, diphenhydramine, acetaminophen, acetaminophen, acetaminophen, acetaminophen, cyanocobalamin, cyanocobalamin, ascorbic acid, ascorbic acid, cholecalciferol, cholecalciferol, cetirizine, cetirizine
Kruklar Disease Interaction
Major: colitis, QT prolongationModerate: renal dysfunction, myasthenia gravis
Elimination Route
Kruklar is well-absorbed, acid stable and may be taken with food.
Half Life
3-4 hours
Elimination Route
After a 250 mg tablet every 12 hours, approximately 20% of the dose is excreted in the urine as clarithromycin, while after a 500 mg tablet every 12 hours, the urinary excretion of clarithromycin is somewhat greater, approximately 30%.
Pregnancy & Breastfeeding use
Kruklar is not recommended for pregnant women. Breast milk from mothers receiving Kruklar should not be given to infants until treatment is completed. Kruklar may be used in neonates and children in appropriate doses.
Contraindication
Hypersensitive to Kruklar, Erythromycin or any of the macrolide antibiotics. Patients receiving terfenadine who have pre-existing cardiac abnormalities or electrolyte disturbances.
Special Warning
Kruklar may be used in neonates and children in appropriate doses.
Acute Overdose
Signs & Symptoms : Ingestion of large amounts of Kruklar can be expected to produce gastrointestinal symptoms. Symptoms of overdose may largely correspond to the profile of side effects.
Management: There is no specific antidote on overdose. Serum levels of Kruklar can not be reduced by haemodialysis or peritoneal dialysis.
Storage Condition
Store in a cool and dry place, protected from light.
Innovators Monograph
You find simplified version here Kruklar
Kruklar contains Clarithromycin see full prescribing information from innovator Kruklar Monograph, Kruklar MSDS, Kruklar FDA label
FAQ
What is Kruklar used for?
Kruklar is used to treat chest infections, such as pneumonia, skin problems such as cellulitis, and ear infections.It is also used to get rid of Helicobacter pylori, a bacteria that can cause stomach ulcers. Kruklar used to treat various bacterial infections. This includes strep throat, pneumonia, skin infections, H. pylori infection, and Lyme disease, among others.
How safe is Kruklar?
Kruklar can be taken by adults and children.Kruklar isn't suitable for some people. To make sure Kruklar is safe for you, tell your doctor if you have allergic reaction to clarithromycin or any other medicines in the past.
Food and Drug Administration is advising caution before prescribing the antibiotic Kruklar to patients with heart disease because of a potential increased risk of heart problems or death that can occur years later.
How does Kruklar work?
Kruklar works by stopping the growth of bacteria. Antibiotics such as clarithromycin will not work for colds, flu, or other viral infections.
What are the common side effects of Kruklar?
Common side effects of Kruklar are include:
- feeling sick (nausea)
- diarrhoea and being sick (vomiting)
- losing your appetite.
- bloating and indigestion.
- headaches.
- difficulty sleeping (insomnia)
Is Kruklar safe during pregnancy?
Kruklar isn't normally recommended during pregnancy and while breastfeeding. But your doctor may prescribe it if the benefits of you taking it are greater than the risks.Kruklar is the antibiotic most often used in pregnancy.
Is Kruklar safe during breastfeeding?
Because of the low levels of Kruklar in breastmilk and safe administration directly to infants, it is acceptable in nursing mothers. The small amounts in milk are unlikely to cause adverse effects in the infant.
Can I drink alcohol with Kruklar?
You can drink alcohol while taking Kruklar.
Can I drive after taking Kruklar?
Avoid driving and doing other tasks or actions that call for you to be alert until you see how this medicine affects you.
When should be taken of Kruklar?
Kruklar usual to take Kruklar twice a day once in the morning and once in the evening.
How quickly does Kruklar work?
You should feel better within a few days. For skin problems such as cellulitis, you may have to take the medicine for about 7 days before you see any improvement.
How long does Kruklar stay in my system?
Kruklar stays in the body for a period of about 8 to 12 hours.
Is Kruklar bad for the heart?
Kruklar may increase the long term risk of heart problems and death in patients with heart disease.
Is Kruklar safe for kidneys?
Kruklar do not cause direct nephrotoxicity in general, but erythromycin and Kruklar can influence kidney function secondary to interactions with other drugs.
Can I take Kruklar long term?
This prospective study demonstrated that 6-month treatment with Kruklar might be necessary to improve the clinical conditions of patients with DPB and Kruklar could be safely used for a long term.
What happens if I miss a dose of Kruklar?
Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
What happens if I overdose on Kruklar?
Seek emergency medical attention.Overdose symptoms may include severe stomach pain, nausea, vomiting, or diarrhea.
Who should not take Kruklar?
Your doctor will probably tell you not to take Kruklar if you are taking one or more of these medications. Tell your doctor if you have or have ever had jaundice or other liver problems while taking Kruklar. Your doctor will probably tell you not to take Kruklar.
Is Kruklar good for Covid?
Kruklar seems likely that treatment of patients with COVID-19 with oral Kruklar will substantially increase their anti-inflammatory properties and decrease the chances for development of severe respiratory failure.
What happen If I stop taking Kruklar?
If you stop taking Kruklar too soon, or skip doses, your infection may not be completely treated and the bacteria may become resistant to antibiotics.