Clarithromycin

Macrolide for Rhodococcus equi pneumonia in foals (extralabel), respiratory infections, Helicobacter in cats, and Mycobacterium infections. Macrolide antibiotic. Mechanism: 50S ribosomal subunit binding → inhibits bacterial translocation and protein synthesis. Superior intracellular penetration vs. erythromycin; active against Rhodococcus equi, Mycobacterium, and Helicobacter. Active metabolite (14-OH clarithromycin). Significant CYP3A4 drug interactions. Key information Administer with food to reduce GI upset. Significant drug interactions (CYP3A4 inhibitor) — check interactions carefully. Foals: used for Rhodococcus equi with rifampin. Bitter taste — use compounded flavored preparations if compliance is an issue.

Oral: Administer orally. May be given with food to improve compliance and reduce GI upset. Administer with food to reduce GI adverse effects. to reduce GI upset. Suspension: Shake well before each use. Store refrigerated (2–8°C); do not freeze. Monitor body temperature in foals daily. Store at room temperature; protect from light. (tablets). If a dose is missed Administer as soon as you remember. If it is almost time for the next scheduled dose, skip the missed dose and resume the normal schedule. Never double up doses to make up for a missed one. Administer with food. Complete the full course.

GI: diarrhea, vomiting. QT prolongation. Hepatotoxicity. Foals: foal diarrhea, hyperthermia, macrolide-associated diarrhea in mares nursing treated foals (mares should not be in same paddock). CYP3A4 interactions (rifampin, theophylline, digoxin levels affected).

For animals Foals: hyperthermia/diarrhea risk and severe macrolide-associated diarrhea in nursing mares — separate mares from treated foals. QT prolongation risk. Monitor liver enzymes with prolonged use. CYP3A4 interactions. For people handling this medication Wash hands thoroughly with soap and water after handling. Avoid contact with eyes; if contact occurs, flush with water for 15 minutes and seek medical attention. Keep out of reach of children. If accidental ingestion occurs, contact Poison Control (1-800-222-1222). Macrolide antibiotic — Wash hands thoroughly with soap and water after handling. after handling. Keep out of reach of children. Pregnant women and women of childbearing age should avoid contact. Potential teratogen.

Contact your veterinarian. Overdose causes GI signs and possible cardiac arrhythmias. Contact your veterinarian, a veterinary emergency clinic, or the ASPCA Animal Poison Control Center (888-426-4435) immediately. Do not induce vomiting unless specifically directed by a veterinary professional.