GlobalRPh Renal Dosing Masterv6.6
GlobalRPh source record

Clarithromycin

Local official-label summaryBase record retrieved 2026-09-05See the evidence for this drug3 sources available - open source summaries, references and comparisons
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Official source

Clarithromycin immediate-release tablets, USP

Product / population
Adult oral immediate-release tablets; not an IV or extended-release regimen.
Renal measure
Not specified; verify before use
Baseline adult examples

Sinusitis: 500 mg every 12 hours for 14 days. Community-acquired pneumonia: 250 mg every 12 hours for 7-14 days. For disseminated MAC treatment, 500 mg every 12 hours with other antimycobacterial agents. These are label regimens, not endorsement as current empiric first-line choices.

Renal impairment and interactions

At CrCl <30 mL/min, reduce the selected dose by 50%. With atazanavir or a ritonavir-containing regimen, the renal table calls for a 50% reduction at CrCl 30-60 and a 75% reduction below 30. Atazanavir itself requires a 50% reduction. Do not combine independently calculated reductions.

High-risk combination

Concomitant colchicine is contraindicated in renal or hepatic impairment. Review the complete interaction and QT-risk warnings before selecting therapy.

Source revision: | Retrieved: 2026-09-05. Retrieval date is not the revision date.

Source: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=98580dee-d2f4-4f62-a2d4-7434bab2421e

Scope: Source-read local summary; source-specific recommendations are not automatically interchangeable. GlobalRPh v6.6.

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Retrieved: 2026-09-05

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Official product label

Clarithromycin immediate-release tablets, USP

Adult oral immediate-release tablets; not an IV or extended-release regimen.

Renal method: See source.
Retrieved: 2026-09-05

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Handbook

Renal Drug Handbook, fifth edition

Historical 2019 reference; renal bands retain the book's own method labels.

Renal method: See source.
Retrieved: 2026-09-05

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Original content / product scopeClarithromycin immediate-release tablets, USPRenal Drug Handbook, fifth edition
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Historical source content is not a current prescription. Original GlobalRPh recommendations are preserved, not automatically certified as current. Product-label and professional additions below are separately attributed. Confirm indication, population, kidney-function method, monitoring and the full prescribing information before applying a regimen.

Important source distinctions

Historical H. pylori regimens, the pediatric weight table and lifelong MAC statement are preserved from the source; they are not independently verified current treatment recommendations. IR and XL are distinct formulations.

The handbook renal dose ranges and selected U.S. label dose-reduction rules differ. Current label instructions and patient-specific interactions must be reviewed; the sources are not counted as agreeing.

Locally stored source content

Original GlobalRPh protocol

Clinical facts and comments transcribed into a structured reading format. This is not a byte-for-byte HTML archive. Original source: https://globalrph.com/renal/clarithromycin/

Usual Dosing (Adults)

BIAXIN immediate-release tablets and granules for suspension may be given with or without food. BIAXIN XL extended-release tablets should be taken with food and swallowed whole, not chewed, broken or crushed. Hepatic impairment alone does not require adjustment when renal function is normal.

Source adult dosage table (IR doses every 12 hours; XL doses every 24 hours):

Infection/pathogenIR dose and durationXL dose and duration
Pharyngitis/tonsillitis, S. pyogenes250 mg for 10 daysNot listed
Acute maxillary sinusitis, H. influenzae, M. catarrhalis, S. pneumoniae500 mg for 14 daysTwo 500 mg tablets for 14 days
Acute exacerbation chronic bronchitis, H. influenzae500 mg for 7 to 14 daysTwo 500 mg tablets for 7 days
Acute exacerbation chronic bronchitis, H. parainfluenzae500 mg for 7 daysTwo 500 mg tablets for 7 days
Acute exacerbation chronic bronchitis, M. catarrhalis or S. pneumoniae250 mg for 7 to 14 daysTwo 500 mg tablets for 7 days
Community-acquired pneumonia, H. influenzae250 mg for 7 daysTwo 500 mg tablets for 7 days
Community-acquired pneumonia, H. parainfluenzae or M. catarrhalisNot listedTwo 500 mg tablets for 7 days
Community-acquired pneumonia, S. pneumoniae, C. pneumoniae or M. pneumoniae250 mg for 7 to 14 daysTwo 500 mg tablets for 7 days
Uncomplicated skin/skin structure, S. aureus or S. pyogenes250 mg for 7 to 14 daysNot listed

H. pylori eradication to reduce duodenal-ulcer recurrence:

Triple therapy with lansoprazole: clarithromycin 500 mg, lansoprazole 30 mg and amoxicillin 1 g, all twice daily for 10 or 14 days.

Triple therapy with omeprazole: clarithromycin 500 mg, omeprazole 20 mg and amoxicillin 1 g, all twice daily for 10 days. If an ulcer is present at initiation, continue omeprazole 20 mg daily for an additional 18 days.

Dual therapy with omeprazole: clarithromycin 500 mg three times daily plus omeprazole 40 mg each morning for 14 days, then omeprazole 20 mg daily for another 14 days.

Dual therapy with ranitidine bismuth citrate: clarithromycin 500 mg twice or three times daily plus ranitidine bismuth citrate 400 mg twice daily for 14 days, then ranitidine bismuth citrate 400 mg twice daily for another 14 days. This combination is not recommended at CrCl <25 mL/min.

Children: usual 15 mg/kg/day in two doses for 10 days. The source pediatric table, based on 7.5 mg/kg every 12 hours, lists:

WeightDose every 12 hours125 mg/5 mL volume250 mg/5 mL volume
9 kg (20 lb)62.5 mg2.5 mL1.25 mL
17 kg (37 lb)125 mg5 mL2.5 mL
25 kg (55 lb)187.5 mg7.5 mL3.75 mL
33 kg (73 lb)250 mg10 mL5 mL

Mycobacterial prophylaxis: adult 500 mg twice daily; pediatric 7.5 mg/kg twice daily, up to 500 mg twice daily. The source notes no pediatric MAC prophylaxis studies; these doses were derived from pediatric treatment studies.

Disseminated MAC treatment: clarithromycin is described as a primary agent used with other antimycobacterial drugs showing in-vitro activity or clinical benefit. Adult 500 mg twice daily; pediatric 7.5 mg/kg twice daily up to 500 mg twice daily. The historical page states therapy should continue for life if clinical and mycobacterial improvement is observed.

GRPH-clarithromycin-01 · Source section: Usual Dosing (Adults)Renal section finder

Renal Dosing

CrCl <30 mL/min: reduce clarithromycin dose by 50%. With concomitant atazanavir or ritonavir, reduce the dose by 50% at CrCl 30 to 60 mL/min or 75% at CrCl <30 mL/min.

GRPH-clarithromycin-02 · Source section: Renal DosingRenal section finder

Hemodialysis

See above. Schedule dose after hemodialysis on dialysis days.

GRPH-clarithromycin-03 · Source section: HemodialysisRenal section finder
Separate U.S. product-label layer

FDA / DailyMed dosing and renal information

Official

Clarithromycin immediate-release tablets, USP

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NIH/NLM DailyMed - U.S. prescribing information · Adult oral immediate-release tablets; not an IV or extended-release regimen.

Renal method: Not specified in this summary.
Source date:
Retrieved: 2026-09-05

Source-read local summary; source-specific recommendations are not automatically interchangeable.

Baseline adult examples

Sinusitis: 500 mg every 12 hours for 14 days. Community-acquired pneumonia: 250 mg every 12 hours for 7-14 days. For disseminated MAC treatment, 500 mg every 12 hours with other antimycobacterial agents. These are label regimens, not endorsement as current empiric first-line choices.

clarithromycin:dm-98580dee-d2f4-4f62-a2d4-7434bab2421e-1 · Source locator: 2.2, Table 1; 2.5

Renal impairment and interactions

At CrCl <30 mL/min, reduce the selected dose by 50%. With atazanavir or a ritonavir-containing regimen, the renal table calls for a 50% reduction at CrCl 30-60 and a 75% reduction below 30. Atazanavir itself requires a 50% reduction. Do not combine independently calculated reductions.

clarithromycin:dm-98580dee-d2f4-4f62-a2d4-7434bab2421e-2 · Source locator: 2.6, Table 2; 2.7

High-risk combination

Concomitant colchicine is contraindicated in renal or hepatic impairment. Review the complete interaction and QT-risk warnings before selecting therapy.

clarithromycin:dm-98580dee-d2f4-4f62-a2d4-7434bab2421e-3 · Source locator: 4.4; 5.2; 7

Source identity and provenance
Source
https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=98580dee-d2f4-4f62-a2d4-7434bab2421e
Retrieved
2026-09-05
Exact label title
Clarithromycin immediate-release tablets, USP
DailyMed Set ID
98580dee-d2f4-4f62-a2d4-7434bab2421e
Labeler
Ajanta Pharma USA Inc.
DailyMed page updated
2023-12-05
FDA application
Abbreviated New Drug Application
U.S. product identity basis
Exact named product and route appear in the selected U.S. prescription label; current retail availability was not independently assessed.
Hash meaning
Locally authored source summary, not original SPL/XML/PDF bytes
Local summary SHA-256
6cae6e371b2e896b7bfd9637296a42fb522296fc33a1cf26e8a14bd70e4096c9
Separate handbook layer

Renal Drug Handbook cross-check

Handbook

Renal Drug Handbook, fifth edition

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UK Renal Pharmacy Group / Ashley and Dunleavy / CRC Press · Historical 2019 reference; renal bands retain the book's own method labels.

Renal method: Not specified in this summary.
Source date: Not established
Retrieved: 2026-09-05

Historical handbook facts locally summarized; not a current U.S. label or a modern CRRT protocol.

Historical renal and dialysis statements

The handbook lists normal dosing at GFR 30-50 and oral 250-500 mg every 12 hours in both 10-30 and <10 bands. Its HD/APD/CAPD rows say not dialysed and refer to the <10 band; high-flux and continuous clearance are unknown. It warns about high-dose vomiting below 10 and the potentially fatal colchicine interaction.

clarithromycin:rdh5-223-224-1 · Source locator: Renal impairment; replacement therapies; Other information; interactions

Source-specific limits

The book's dose ranges do not consistently implement the current selected U.S. label's 50% reduction. The IV and XL regimens in the book are not transferred into this immediate-release U.S. tablet summary. No Stanford validation is asserted.

Source identity and provenance
Retrieved
2026-09-05
Handbook page
Printed page 223-224; PDF page 242-243
Hash meaning
Locally authored source summary, not original SPL/XML/PDF bytes
Local summary SHA-256
16b6de30b183eb2fd367ac240597692c0448f5097179500cd2959f66dc9980e5

Provenance and preservation

Additional summaries stored on this page: 1 official-label, 0 RX List, 0 professional, 1 handbook. Empty additional-source groups are not shown. A missing layer is not a no-adjustment recommendation.

Original source
https://globalrph.com/renal/clarithromycin/
Source retrieval
2026-09-05. This is not the source publication or label revision date.
Original source type
globalrph individual
Local text SHA-256
aa3000fec0dc6b8fe7bdf2c2999d465a33dc52558dc7c11182196b98fadc418e
Import versus clinical validation
Source-section locators identify where retained content came from. A source-section identifier does not assert that every numeric statement has been independently corroborated. The local text hash is not a hash of original HTML, an FDA PDF or SPL XML.

The original individual GlobalRPh pages commonly cite NIH/NLM DailyMed and instruct readers to review the applicable package insert for updates. That historical reference is preserved as context; it is not counted as an independently retrieved current label.

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