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Clarithromycin 125mg/5ml Granules For Oral Suspension

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Ref: LTT0204/311215/1/F

Klaricid ® 125mg/5ml Paediatric Suspension

(clarithromycin)

Patient Information Leaflet

Read all of this leaflet carefully before you give this medicine to your child because it contains important information

*    Keep this leaflet. You may need to read it again.

*    If you have further questions, ask your doctor or your pharmacist.

*    This medicine has been prescribed for your child only. Do not pass it on to others. It may harm them, even if their symptoms are the same as your child's.

*    If your child gets any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.

Your medicine is called Klaricid 125mg/5ml Paediatric Suspension and will be referred to as Klaricid Paediatric Suspension throughout the rest of this leaflet.

What is in this leaflet:

What Klaricid Paediatric Suspension is and what it is used for What you need to know before giving Klaricid Paediatric Suspension ^ How to give Klaricid Paediatric Suspension Possible side effects

How to store Klaricid Paediatric Suspension Contents of the pack and other information

^ What Klaricid Paediatric Suspension is and what it is used for

Each 5ml spoonful of Klaricid Paediatric Suspension contains 125 mg of the active ingredient clarithromycin.

Klaricid belongs to a group of medicines called macrolide antibiotics. Antibiotics stop the growth of bacteria (bugs) that cause infections.

It is used to treat infections such as:

1.    Chest infections, such as bronchitis and pneumonia

2.    Throat and sinus infections

3.    Skin and tissue infections

4.    Ear infections particularly inflammation of the middle ear (acute otitis media).

Klaricid Paediatric Suspension is used in children 6 months to 12 years old.

"2 What you need to know before giving Klaricid Paediatric Suspension

Do not give Klaricid Paediatric Suspension to your child if they;

*    are allergic to clarithromycin, other macrolide antibiotics such as erythromycin or azithromycin, or any of the other ingredients of Klaricid Paediatric Suspension.

*    are taking medicines called ergotamine or dihydroergotamine tablets or use ergotamine inhalers for migraine.

*    are taking medicines called terfenadine or astemizole (widely taken for hay fever or allergies) or cisapride (for stomach disorders) or pimozide (for mental health problems) as combining these drugs can sometimes cause serious disturbances in heart rhythm.

*    are taking lovastatin or simvastatin (HMG-CoA reductase inhibitors, commonly known as statins, used to lower levels of cholesterol (a type of fat) in the blood).

*    have low levels of potassium in the blood (a condition known as hypokalaemia).

*    have severe liver disease with kidney disease.

*    have an irregular heart rhythm.

*    are taking medicines called ticagrelor or ranolazine (for heart attack, chest pain or angina).

*    are taking colchicine (usually taken for gout)

Warning and precautions

Talk to your doctor or pharmacist before giving Klaricid Paediatric

Suspension:

*    if your child has any liver or kidney problems

*    if your child has, or is prone to, fungal infections (e.g. thrush)

*    if your child has been told that they have an intolerance to any sugars as Klaricid Paediatric Suspension contains sucrose.

Other medicines and Klaricid paediatric Suspension

Tell your doctor if your child is taking any of the following medicines as their dose may need to be changed or they may need to have regular tests performed:

*    digoxin, quinidine or disopyramide (for heart problems)

*    warfarin (for thinning the blood)

*    carbamazepine, valproate, phenobarbital or phenytoin (for epilepsy)

*    atorvastatin, rosuvastatin (HMG-CoA reductase inhibitors, commonly known as statins, and used to lower levels of cholesterol (a type of fat) in the blood). Statins can cause rhabdomyolosis (a condition which causes the breakdown of muscle tissue which can result in kidney damage) and signs of myopathy (muscle pain or muscle weakness) should be monitored.

*    nateglinide, pioglitazone, repaglinide, rosiglitazone or insulin (used to lower blood glucose levels)

*    theophylline (used in patients with breathing difficulties such as asthma)

*    triazolam, alprazolam or midazolam (sedatives)

*    cilostazol (for poor circulation)

*    omeprazole (for treatment of indigestion and gastric ulcers)

*    methylprednisolone (a corticosteroid)

*    vinblastine (for treatment of cancer)

*    ciclosporin, sirolimus and tacrolimus (immune suppressants)

*    etravirine, efavirenz, nevirapine, ritonavir, zidovudine, atazanavir, saquinavir (anti-viral drugs used in the treatment of HIV)

*    rifabutin, rifampicin, rifapentine, fluconazole, itraconazole (used in the treatment of certain bacterial infections)

*    tolterodine (for overactive bladder)

*    verapamil, amlodipine, diltiazem (for high blood pressure)

*    sildenafil, vardenafil and tadalafil (for impotence in adult males or for use in pulmonary arterial hypertension (high blood pressure in the blood vessels of the lung))

*    St John's Wort (a herbal product used to treat depression)

*    aminoglycosides ( a group of antibiotic to treat certain bacteria for example gentamicin, neomycin) and other medicines that may be toxic to the ear.

Klaricid Paediatric Suspension does not interact with oral contraceptives.

Pregnancy and breast-feeding

The safety of Klaricid Paediatric Suspension in pregnancy and breast-feeding is not known. As Klaricid Paediatric Suspension may be given to girls of child-bearing age you should speak to your doctor before giving this medicine if pregnancy is known or suspected.

Driving and Using Machines:

Klaricid Paediatric Suspension may make you feel dizzy or drowsy. If they affect you or your child in this way do not drive, operate machinery or do anything that requires you to be alert.

[5) How to give Klaricid Paediatric Suspension

Always give Klaricid Paediatric Suspension exactly as your doctor has told you. Check with your doctor or pharmacist if you are not sure how the dose has been worked out for your child.

The usual doses of Klaricid Paediatric Suspension are given below:

Dosage based on body weight

Weight

Age

Dosage

Number of

(kg)

(years)

in mls

5 ml

(twice daily)

spoonfuls (twice daily)

8-11

1-2

2.5

1/2

12-19

3-6

5

1

20-29

7-9

7.5

1 1/2

30-40

10-12

10

2

Children who weigh less than 8kg should be given a dose of 0.3 ml/kg twice a day. Doctors may sometimes prescribe higher or lower doses than these.

Klaricid Paediatric Suspension should be given twice a day, once in the morning and again in the early evening. It can be given at mealtimes if this is more convenient.

You should shake the bottle well before using and close it tightly afterwards. Klaricid Paediatric Suspension is usually given for 5 to 10 days.

Klaricid 125mg/5ml Paediatric Suspension

(clarithromycin)

Patient Information Leaflet (continued)

If you give more Klaricid Paediatric Suspension than you should

If you accidentally give your child more Klaricid Paediatric Suspension in one day than your doctor has told you to, or if your child accidentally swallows some extra medicine, contact your doctor or nearest hospital emergency department immediately. An overdose of Klaricid Paediatric Suspension is likely to cause vomiting and stomach pains.

If you forget to give Klaricid Paediatric Suspension

If you forget to give your child a dose of medicine, give one as soon as you remember. Do not give more Klaricid Paediatric Suspension in one day than your doctor tells you to.

If you stop giving Klaricid Paediatric Suspension

Do not stop giving this medicine even if your child feels beter. It is important to give the medicine for as long as the doctor has told you to, otherwise the problem might come back

If you have any further questions on the use of this medicine, ask your doctor or pharmacist.

Possible side effects

Like all medicines, Klaricid Paediatric Suspension can cause side effects

although not everybody gets them.

If your child suffers from any of the following at any time during their

treatment STOP giving the medicine and contact your doctor immediately:

*    severe or prolonged diarrhoea, which may have blood or mucus in it. Diarrhoea may occur over two months after treatment with clarithromycin, in which case you should still contact your doctor.

*    a rash, difficulty breathing, fainting or swelling of the face and throat. This is a sign that your child may have developed an allergic reaction.

*    yellowing of the skin (jaundice), skin irritation, pale stools, dark urine, tender abdomen or loss of appetite. These are signs that your child's liver may not be working properly.

*    severe skin reactions such as blistering of the skin, mouth, lips, eyes and genitals (symptoms of a rare allergic reaction called Stevens-Johnson syndrome/toxic epidermal necrolysis).

*    muscle pain or weakness known as rhabdomyolysis (a condition which causes the breakdown of muscle tissue which can result in kidney damage).

Common side effects of Klaricid Paediatric Suspension include;

*    headache

*    difficulty sleeping

*    changes in sense of taste

*    stomach problems such as feeling sick, vomiting, stomach pain, indigestion, diarrhoea

*    a change in the way the liver works

*    skin rash

*    increased sweating

Other less common side effects include:

*    high temperature

*    swelling, redness or itchiness of the skin.

*    acne

*    oral or vaginal ‘thrush' (a fungal infection)

*    reduction in the level of certain blood cells (which can make infections more likely or increase the risk of bruising or bleeding)

*    loss of appetite, heartburn, bloating, constipation, wind

*    inflammation of the pancreas

*    anxiety, nervousness, drowsiness, tiredness, dizziness, tremor or shaking

*    confusion, loss of bearings, hallucinations (seeing things), change in sense of reality or panicking, depression, abnormal dreams or nightmares

*    convulsion (fits)

*    ringing in the ears or hearing loss

*    vertigo

*    paraesthesia, more commonly known as "pins and needles"

*    leaking of blood from blood vessels (haemorrhage)

*    inflammation of the mouth or tongue

*    discolouration of the tongue or teeth

*    dry mouth

*    loss of taste or smell or inability to smell properly

*    joint pain

*    muscle spasms, muscle pain or loss of muscle tissue. If your child suffers from myasthenia gravis (a condition in which the muscles become weak and tire easily) or rhabdomyolysis (a condition which causes the breakdown of muscle tissue), clarithromycin may worsen these symptoms.

*    chest pain or changes in heart rhythm such as palpitations

*    a change in the levels of products made by the liver, inflammation of the liver or an inability of the liver to function properly (you may notice yellowing of the skin, dark urine, pale stools or itchiness of the skin)

*    a change in the levels of products produced by the kidney, inflammation of the kidney or an inability of the kidney to function properly (you may notice tiredness, swelling or puffiness in the face, abdomen, thighs or ankles or problems with urination)

*    a change in the levels of certain cells or products found in the blood. Reporting side effects

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

You can also report side effects directly via the Yellow Card Scheme at www.mhra.gov.uk/yellowcard.

By reporting side effects, you can help provide more information on the safety of this medicine.

How to store Klaricid Paediatric Suspension

*    KEEP OUT OF THE SIGHT AND REACH OF CHILDREN.

*    Do not store above 25°C.

*    Do not refrigerate.

*    Klaricid Paediatric Suspension must be used within 14 days of you receiving the bottle from the pharmacist.

*    Do not take this medicine after the expiry date shown on the carton and bottle label. If your doctor tells you to stop taking this medicine, take any remaining medicine back to the pharmacist for safe disposal.

Only keep this medicine if your doctor tells you to.

*    If your medicine becomes discoloured or show any other signs of deterioration, ask your pharmacist who will advise you what to do.

*    Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines that are no longer required. These measures will help to protect the environment.

[m Contents of the pack and other information

What Klaricid Paediatric Suspension contains:

Each 5ml of suspension contains 125 mg of clarithromycin.

Other ingredients are: sucrose, carbomers (carbopol 974P), povidone K90, hypromellose phthalate, castor oil, silicon dioxide, xanthan gum, fruit punch flavour, potassium sorbate, citric acid, maltodextrin, titanium dioxide and water.

What Klaricid Paediatric Suspension looks like and contents of the pack

Klaricid Paediatric Suspension is white to off-white granules for reconstitution which forms a white suspension when reconstituted with water. It is available as plastic bottle of granules, when reconstituted contains 70 ml of suspension.

Manufacturer and Licence Holder

This medicine is manufactured by Aesica Queenborough Limited, Queenborough, Kent ME11 5EL, UK and is procured from within the EU. Product Licence Holder LTT Pharma Limited, Unit 18, Oxleasow Road, East Moons Moat, Redditch, Worcestershire, B98 0RE. Repackaged by Lexon (UK) Limited, Unit 18, Oxleasow Road, East Moons Moat, Redditch, Worcestershire, B98 0RE.

POM PL 33723/0204 Klaricid 125mg/5ml Paediatric Suspension Klaricid is a registered trademark of Abbott Laboratories.

Revision date: 31/12/15

Blind or partially sighted?

Is this leaflet hard to see or read?

Phone LTT Pharma Limited,

Tel: 01527 505414 for help.

Clarithromycin 125mg/5ml Granules for Oral Suspension

Patient Information Leaflet

Read all of this leaflet carefully before you give this medicine to your child because it contains important information

*    Keep this leaflet. You may need to read it again.

*    If you have further questions, ask your doctor or your pharmacist.

*    This medicine has been prescribed for your child only. Do not pass it on to others. It may harm them, even if their symptoms are the same as your child's.

*    If your child gets any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.

Your medicine is called Clarithromycin 125mg/5ml Granules for Oral Suspension and will be referred to as Clarithromycin throughout the rest of this leaflet.

What is in this leaflet:

What Clarithromycin is and what it is used What you need to know before giving Clarithromycin ^ How to give Clarithromycin Possible side effects How to store Clarithromycin Contents of the pack and other information

^ What Clarithromycin is and what it is used for

Each 5ml spoonful of Clarithromycin contains 125 mg of the active ingredient clarithromycin.

Clarithromycin belongs to a group of medicines called macrolide antibiotics. Antibiotics stop the growth of bacteria (bugs) that cause infections.

It is used to treat infections such as:

1.    Chest infections, such as bronchitis and pneumonia

2.    Throat and sinus infections

3.    Skin and tissue infections

4.    Ear infections particularly inflammation of the middle ear (acute otitis media).

Clarithromycin is used in children 6 months to 12 years old.

What you need to know before giving Clarithromycin

Do not give Clarithromycin to your child if they;

*    are allergic to clarithromycin, other macrolide antibiotics such as erythromycin or azithromycin, or any of the other ingredients of Clarithromycin.

*    are taking medicines called ergotamine or dihydroergotamine tablets or use ergotamine inhalers for migraine.

*    are taking medicines called terfenadine or astemizole (widely taken for hay fever or allergies) or cisapride (for stomach disorders) or pimozide (for mental health problems) as combining these drugs can sometimes cause serious disturbances in heart rhythm.

*    are taking lovastatin or simvastatin (HMG-CoA reductase inhibitors, commonly known as statins, used to lower levels of cholesterol (a type of fat) in the blood).

*    have low levels of potassium in the blood (a condition known as hypokalaemia).

*    have severe liver disease with kidney disease.

*    have an irregular heart rhythm.

*    are taking medicines called ticagrelor or ranolazine (for heart attack, chest pain or angina).

*    are taking colchicine (usually taken for gout)

Warning and precautions

Talk to your doctor or pharmacist before giving Clarithromycin

*    if your child has any liver or kidney problems

*    if your child has, or is prone to, fungal infections (e.g. thrush)

*    if your child has been told that they have an intolerance to any sugars as Clarithromycin.

Other nedicines and Clarithromycin

Tell your doctor if your child is taking any of the following medicines as their

dose may need to be changed or they may need to have regular tests

performed:

*    digoxin, quinidine or disopyramide (for heart problems)

*    warfarin (for thinning the blood)

*    carbamazepine, valproate, phenobarbital or phenytoin (for epilepsy)

*    atorvastatin, rosuvastatin (HMG-CoA reductase inhibitors, commonly known as statins, and used to lower levels of cholesterol (a type of fat) in the blood). Statins can cause rhabdomyolosis (a condition which causes the breakdown of muscle tissue which can result in kidney damage) and signs of myopathy (muscle pain or muscle weakness) should be monitored.

*    nateglinide, pioglitazone, repaglinide, rosiglitazone or insulin (used to lower blood glucose levels)

*    theophylline (used in patients with breathing difficulties such as asthma)

*    triazolam, alprazolam or midazolam (sedatives)

*    cilostazol (for poor circulation)

*    omeprazole (for treatment of indigestion and gastric ulcers)

*    methylprednisolone (a corticosteroid)

*    vinblastine (for treatment of cancer)

*    ciclosporin, sirolimus and tacrolimus (immune suppressants)

*    etravirine, efavirenz, nevirapine, ritonavir, zidovudine, atazanavir, saquinavir (anti-viral drugs used in the treatment of HIV)

*    rifabutin, rifampicin, rifapentine, fluconazole, itraconazole (used in the treatment of certain bacterial infections)

*    tolterodine (for overactive bladder)

*    verapamil, amlodipine, diltiazem (for high blood pressure)

*    sildenafil, vardenafil and tadalafil (for impotence in adult males or for use in pulmonary arterial hypertension (high blood pressure in the blood vessels of the lung))

*    St John's Wort (a herbal product used to treat depression)

*    aminoglycosides ( a group of antibiotic to treat certain bacteria for example gentamicin, neomycin) and other medicines that may be toxic to the ear.

Clarithromycin does not interact with oral contraceptives.

Pregnancy and breast-feeding

The safety of Clarithromycin in pregnancy and breast-feeding is not known. As Clarithromycin may be given to girls of child-bearing age you should speak to your doctor before giving this medicine if pregnancy is known or suspected.

Driving and Using Machines:

Clarithromycin may make you feel dizzy or drowsy. If they affect you or your child in this way do not drive, operate machinery or do anything that requires you to be alert.

How to give Clarithromycin

Always give Clarithromycin exactly as your doctor has told you. Check with your doctor or pharmacist if you are not sure how the dose has been worked out for your child.

The usual doses of Clarithromycin are given below:

Dosage based on body weight

Weight

Age

Dosage

Number of

(kg)

(years)

in mls

5 ml

(twice daily)

spoonfuls (twice daily)

8-11

1-2

2.5

1/2

12-19

3-6

5

1

20-29

7-9

7.5

1 1/2

30-40

10-12

10

2

Children who weigh less than 8kg should be given a dose of 0.3 ml/kg twice a day.

Doctors may sometimes prescribe higher or lower doses than these.

Clarithromycin should be given twice a day, once in the morning and again in the early evening. It can be given at mealtimes if this is more convenient. You should shake the bottle well before using and close it tightly afterwards. Clarithromycin is usually given for 5 to 10 days.

If you give more Clarithromycin than you should

If you accidentally give your child more Clarithromycin in one day than your doctor has told you to, or if your child accidentally swallows some extra medicine, contact your doctor or nearest hospital emergency department immediately. An overdose of Clarithromycin is likely to cause vomiting and stomach pains.

If you forget to give Clarithromycin

If you forget to give your child a dose of medicine, give one as soon as you remember. Do not give more Clarithromycin in one day than your doctor tells you to.

Clarithromycin 125mg/5ml Granules for Oral Suspension

Patient Information Leaflet (continued)

If you stop giving Clarithromycin

Do not stop giving this medicine even if your child feels beter. It is important to give the medicine for as long as the doctor has told you to, otherwise the problem might come back

If you have any further questions on the use of this medicine, ask your doctor or pharmacist.

Reporting side effects

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

You can also report side effects directly via the Yellow Card Scheme at www.mhra.gov.uk/yellowcard.

By reporting side effects, you can help provide more information on the safety of this medicine.

Possible side effects

Like all medicines, Clarithromycin can cause side effects although not

everybody gets them.

If your child suffers from any of the following at any time during their

treatment STOP giving the medicine and contact your doctor immediately:

*    severe or prolonged diarrhoea, which may have blood or mucus in it. Diarrhoea may occur over two months after treatment with clarithromycin, in which case you should still contact your doctor.

*    a rash, difficulty breathing, fainting or swelling of the face and throat. This is a sign that your child may have developed an allergic reaction.

*    yellowing of the skin (jaundice), skin irritation, pale stools, dark urine, tender abdomen or loss of appetite. These are signs that your child's liver may not be working properly.

*    severe skin reactions such as blistering of the skin, mouth, lips, eyes and genitals (symptoms of a rare allergic reaction called Stevens-Johnson syndrome/toxic epidermal necrolysis).

*    muscle pain or weakness known as rhabdomyolysis (a condition which causes the breakdown of muscle tissue which can result in kidney damage).

Common side effects of Clarithromycin include;

*    headache

*    difficulty sleeping

*    changes in sense of taste

*    stomach problems such as feeling sick, vomiting, stomach pain, indigestion, diarrhoea

*    a change in the way the liver works

*    skin rash

*    increased sweating

Other less common side effects include:

*    high temperature

*    swelling, redness or itchiness of the skin.

*    acne

*    oral or vaginal ‘thrush' (a fungal infection)

*    reduction in the level of certain blood cells (which can make infections more likely or increase the risk of bruising or bleeding)

*    loss of appetite, heartburn, bloating, constipation, wind

*    inflammation of the pancreas

*    anxiety, nervousness, drowsiness, tiredness, dizziness, tremor or shaking

*    confusion, loss of bearings, hallucinations (seeing things), change in sense of reality or panicking, depression, abnormal dreams or nightmares

*    convulsion (fits)

*    ringing in the ears or hearing loss

*    vertigo

*    paraesthesia, more commonly known as "pins and needles"

*    leaking of blood from blood vessels (haemorrhage)

*    inflammation of the mouth or tongue

*    discolouration of the tongue or teeth

*    dry mouth

*    loss of taste or smell or inability to smell properly

*    joint pain

*    muscle spasms, muscle pain or loss of muscle tissue. If your child suffers from myasthenia gravis (a condition in which the muscles become weak and tire easily) or rhabdomyolysis (a condition which causes the breakdown of muscle tissue), clarithromycin may worsen these symptoms.

*    chest pain or changes in heart rhythm such as palpitations

*    a change in the levels of products made by the liver, inflammation of the liver or an inability of the liver to function properly (you may notice yellowing of the skin, dark urine, pale stools or itchiness of the skin)

*    a change in the levels of products produced by the kidney, inflammation of the kidney or an inability of the kidney to function properly (you may notice tiredness, swelling or puffiness in the face, abdomen, thighs or ankles or problems with urination)

*    a change in the levels of certain cells or products found in the blood.

^ How to store Clarithromycin

*    KEEP OUT OF THE SIGHT AND REACH OF CHILDREN.

*    Do not store above 25°C.

*    Do not refrigerate.

*    Clarithromycin must be used within 14 days of you receiving the bottle from the pharmacist.

*    Do not take this medicine after the expiry date shown on the carton and bottle label. If your doctor tells you to stop taking this medicine, take any remaining medicine back to the pharmacist for safe disposal.

Only keep this medicine if your doctor tells you to.

*    If your medicine becomes discoloured or show any other signs of deterioration, ask your pharmacist who will advise you what to do.

*    Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines that are no longer required. These measures will help to protect the environment.

Contents of the pack and other information

What Clarithromycin contains:

Each 5ml of suspension contains 125 mg of clarithromycin.

Other ingredients are: sucrose, carbomers (carbopol 974P), povidone K90, hypromellose phthalate, castor oil, silicon dioxide, xanthan gum, fruit punch flavour, potassium sorbate, citric acid, maltodextrin, titanium dioxide and water.

What Clarithromycin looks like and contents of the pack

Clarithromycin is white to off-white granules for reconstitution which forms a white suspension when reconstituted with water. It is available as plastic bottle of granules, when reconstituted contains 70 ml of suspension.

Manufacturer and Licence Holder

This medicine is manufactured by Aesica Queenborough Limited, Queenborough, Kent ME11 5EL, UK and is procured from within the EU. Product Licence Holder LTT Pharma Limited, Unit 18, Oxleasow Road, East Moons Moat, Redditch, Worcestershire, B98 0RE. Repackaged by Lexon (UK) Limited Unit 18, Oxleasow Road, East Moons Moat, Redditch, Worcestershire, B98 0RE.

POM PL 33723/0204

Revision date: 31/12/15

Blind or partially sighted?

Is this leaflet hard to see or read? Phone LTT Pharma Limited,

Tel: 01527 505414 for help.