Common brand name: Biaxin.
Dental uses: Clarithromycin is an antibiotic related to erythromycin. Its main use in dentistry is in patients who are allergic to penicillins and who are at risk of developing bacterial endocarditis, a serious and potentially fatal heart infection, following dental procedures likely to induce mucosal or gingival bleeding. Such procedures include dental extractions, periodontal surgery, professional cleanings, orthodontic band (not bracket) placement and some other procedures. Patients considered at risk are those with prosthetic heart valves, those with mitral valve prolapse with valvular regurgitation (a heart murmur with leaky valves) and those who previously contracted endocarditis, in addition to people with some other cardiac conditions.
Clarithromycin also is used in patients with allergies to penicillins who have dental infections, including abscesses, infections around third molars and infections after dental surgery. It also is used in patients in whom other drugs have proved ineffective.
Dosages for dental purposes: For patients at risk for endocarditis, the recommended dose is 500 milligrams one hour before the dental procedure. For patients with dental infections, the typical dose is 250 milligrams to 500 milligrams every 12 hours for seven to 10 days.
Concerns and possible side effects: Although more expensive than erythromycin, clarithromycin is better tolerated with respect to gastrointestinal complaints (abdominal pain, nausea, vomiting and diarrhea). It does occasionally produce abnormal taste sensations.
In addition, like erythromycin, clarithromycin causes the accumulation of a number of drugs in the body if taken concurrently. These include:
The asthma drug theophylline (brand name, Theo-dur)
The non-sedating antihistamines terfenadine (brand name, Seldane) and astemizole (brand name, Hismanal)
The blood-thinning agents warfarin and dicumarol (brand name, Coumadin)
The “statin” cholesterol-lowering drugs such as lovastatin (brand name, Mevacor), simvastatin (brand name, Zocor) and atorvastatin (brand name, Lipitor)
This list is not complete, and it continues to grow. These interactions with clarithromycin are potentially serious and life threatening. It is imperative to inform your dentist of all medications you are currently taking to avoid serious drug interactions.