Clarithromycin

J01F - Macrolides, lincosamides and streptogramins ATC J01FA09 Small molecule approved 1991 Oral Natural product

🧬 Cross-allergy: Macrolides

JFDA label: Claridar Suspension

Mechanism of Action

Inhibitor of Bacterial 70S ribosome — Bacterial 70S ribosome inhibitor

Target	Action	Gene / class
Bacterial 70S ribosome efficacy	INHIBITOR

Indications

Approved

Bronchitis, acute bacterial exacerbation
Helicobacter pylori eradication
Mycobacterial infections, disseminated
Otitis media
Pharyngitis/tonsillitis
Pneumonia, community-acquired
Sinusitis
Skin/skin structure infections

Off-label

Bartonellosis infection (treatment/long-term suppressive therapy) in HIV-infected patients (adolescents and adults)
Infective endocarditis (prophylaxis)
Lyme disease
Pertussis
Pneumonia, community acquired (children)

Antimicrobial Spectrum

Expected / intrinsic spectrum (EUCAST breakpoints & labels) — not local resistance. Source: EUCAST v16 · curated.

Bacteria

Organism	Activity	MIC
Haemophilus influenzae	Susceptible	8.0 mg/L
Helicobacter pylori	Susceptible	0.25 mg/L
Helicobacter pylori	Susceptible	0.25 mg/L
Moraxella catarrhalis	Susceptible	0.251 mg/L
Mycobacterium avium complex	Susceptible	8.0 mg/L
Mycoplasma pneumoniae	Susceptible	0.5 mg/L
Staphylococcus spp.	Susceptible	11.0 mg/L
Streptococcus A/B/C/G	Susceptible	0.251 mg/L
Streptococcus pneumoniae	Susceptible	0.25 mg/L
Streptococcus pneumoniae	Susceptible	0.251 mg/L
Streptococcus pyogenes	Susceptible	0.25 mg/L
Helicobacter pylori	Resistant	0.5 mg/L
Streptococcus pneumoniae	Resistant	1.0 mg/L

Class profile

gramStatus	Both
spectrumBreadth	Broad
atypicalCoverage	Yes
isBactericidal	0
moaCategory	Protein synthesis inhibitor (50S ribosomal, 23S rRNA)
pdIndex	Time-dependent
postAntibioticEffect	Prolonged
mrsaCoverage	0
resistanceMechanisms	Target site methylation (erm genes),Active efflux (mef genes),Ribosomal mutation

Contraindications

Source: Lexicomp · Curated

Additional contraindications (not in US labeling): Severe hepatic failure in combination with renal impairment Absolute
History of QT prolongation or concurrent QT-prolonging drugs Absolute
Hypersensitivity to clarithromycin, erythromycin, any of the macrolide antibiotics, or any component of the formulation Absolute
Pregnancy — teratogenic potential in first trimester Absolute
concomitant use with astemizole, terfenadine, or ranolazine (not available in Canada) Absolute
concomitant use with cisapride, pimozide, ergot alkaloids (eg, ergotamine, dihydroergotamine), or HMG-CoA reductase inhibitors extensively metabolized by CYP3A4 (eg, lovastatin, simvastatin) Absolute
concomitant use with colchicine in patients with renal or hepatic impairment Absolute
concomitant use with saquinavir, midazolam (oral), colchicine (regardless of hepatic/renal impairment), ticagrelor Absolute
history of QT prolongation (congenital or documented acquired QT prolongation or ventricular cardiac arrhythmia, including torsades de pointes Absolute
history of cholestatic jaundice/hepatic dysfunction associated with prior use of clarithromycin Absolute
hypokalemia Absolute

Adverse Reactions

Very Common >10%Common 1–10%Uncommon 0.1–1% Rare 0.01–0.1%Very Rare <0.01%Not Known

Cardiac disorders (1)

Uncommon QT prolongation / torsades de pointes

Nervous system disorders (3)

Common Headache · Headache · insomnia

Hepatobiliary disorders (3)

Common Abnormal hepatic function tests

Uncommon Elevated liver enzymes

Rare Hepatotoxicity (cholestatic jaundice)

Renal and urinary disorders (1)

Common Increased blood urea nitrogen

Blood and lymphatic system disorders (1)

Common Prolonged prothrombin time

Immune system disorders (2)

Common Anaphylactoid reaction

Uncommon Hypersensitivity / rash

Gastrointestinal disorders (10)

Common Abdominal pain · abdominal pain · Abnormal taste / dysgeusia · diarrhea · Diarrhoea · Dysgeusia · dyspepsia · Nausea · nausea · vomiting

Skin and subcutaneous tissue disorders (1)

Common Skin rash

Psychiatric disorders (1)

Common Insomnia

Infections and infestations (1)

Common Candidiasis (including oral)

Dosing

Source: Lexicomp

Usual dosage range: Oral: 250 to 500 mg every 12 hours or 1000 mg (two 500 mg extended-release tablets) once daily for 7 to 14 days Bronchitis, acute bacterial exacerbation: Oral: M. catarrhalis and S. pneumoniae: 250 mg every 12 hours for 7 to 14 days or 1,000 mg (two 500 mg extended-release tablets) once daily for 7 days H. influenzae: 500 mg every 12 hours for 7 to 14 days or 1,000 mg (two 500 mg extended-release tablets) once daily for 7 days H. parainfluenzae: 500 mg every 12 hours for 7 days or 1,000 mg (two 500 mg extended-release tablets) once daily for 7 days Bartonellosis in HIV-infected patients (excluding CNS infections and endocarditis) (off-label use; HHS [OI adult 2015]): Oral: Treatment (alternative to preferred): 500 mg twice daily for at least 3 months Long-term suppressive therapy: 500 mg twice daily; may discontinue if completed 3 to 4 months therapy and CD4 >200 cells/mm3 for at least 6 months. Note: Some clinicians would discontinue only if Bartonella titers have also decreased four-fold H. pylori eradication: Oral: American College of Gastroenterology guidelines (Chey 2007; Chey 2017): Clarithromycin triple therapy: 500 mg twice daily, in combination with a standard-dose or double-dose proton pump inhibitor, and either amoxicillin 1 g twice daily or metronidazole 500 mg three times daily; continue regimen for 14 days. Note: Avoid use of clarithromycin triple therapy in patients with risk factors for macrolide resistance (eg, prior macrolide exposure, local clarithromycin resistance rates ≥15%, eradication rates with clarithromycin-based regimens ≤85%) (ACG [Chey 2017]; Fallone 2016). Concomitant regimen: 500 mg twice daily in combination with amoxicillin 1 g twice daily, and a standard-dose proton pump inhibitor twice daily, and either metronidazole or tinidazole 500 mg twice daily; continue treatment for 10 to 14 days. Sequential regimen: Amoxicillin 1 g twice daily plus a standard-dose proton pump inhibitor twice daily for 5 to 7 days; then follow with clarithromycin 500 mg twice daily, and a standard-dose proton pump inhibitor twice daily, and either metronidazole or tinidazole 500 mg twice daily for 5 to 7 days. Hybrid regimen: Amoxicillin 1 g twice daily plus a standard-dose proton pump inhibitor twice daily for 7 days; then follow with amoxicillin 1 g twice daily, clarithromycin 500 mg twice daily, a standard-dose PPI twice daily, and either metronidazole or tinidazole 500 mg twice daily for 7 days. Lyme disease (off-label use): Oral: 500 mg twice daily for 14 to 21 days (not recommended for pregnant women) (Wormser 2006) Mycobacterial infection, disseminated (prophylaxis and treatment): Oral: Manufacturer's labeling: 500 mg twice daily (use with other antimycobacterial drugs, eg, ethambutol or rifampin). Continue therapy if clinical response is observed; may discontinue when patient is considered at low risk of disseminated infection. Alternate dosing: Mycobacterium avium complex disease (MAC) in HIV-infected patient

(For additional information see "Clarithromycin: Pediatric drug information") Usual dosage range: Note: All pediatric dosing recommendations based on immediate release product formulations (tablet and oral suspension): Infants ≥6 months, Children, and Adolescents: Oral: 7.5 mg/kg every 12 hours (maximum: 500 mg/dose) for 10 days Bartonellosis in (treatment/long-term suppressive therapy) HIV-infected patients (excluding CNS infections and endocarditis) (off-label use): Adolescents: Oral: Refer to adult dosing. Lyme disease (off-label use): Infants, Children, and Adolescents: Oral: 7.5 mg/kg/dose (maximum dose: 500 mg) twice daily for 14-21 days (Wormser 2006) Mycobacterial infection, disseminated (prevention and treatment): Oral: Manufacturer's labeling: 7.5 mg/kg/dose (maximum: 500 mg/dose) twice daily; use in combination with other antimycobacterial agents for the treatment of disseminated MAC. Note: Safety of clarithromycin for MAC not studied in children Alternative recommendations: Disseminated Mycobacterium avium complex (MAC) disease in HIV-exposed/-positive patients: Infants and children (CDC 2009): Primary prophylaxis: 7.5 mg/kg/dose (maximum: 500 mg/dose) twice daily Secondary prophylaxis: 7.5 mg/kg/dose (maximum: 500 mg/dose) twice daily, plus ethambutol, with or without rifabutin Treatment: 7.5-15 mg/kg/dose (maximum: 500 mg/dose) twice daily plus ethambutol, plus rifabutin (for severe disease) Adolescents: Refer to adult dosing. Otitis media: Infants ≥6 months, Children, and Adolescents: Oral: 7.5 mg/kg/dose (maximum: 500 mg/dose) every 12 hours for 10 days. Note: Due to increased S. pneumoniae and H. influenzae resistance, macrolides are not routinely recommended as a treatment option (Lieberthal 2013) Pertussis (off-label use): Infants ≥1 month, Children, and Adolescents: Oral: 7.5 mg/kg/dose (maximum: 500 mg/dose) every 12 hours for 7 days (CDC 2005) Pharyngitis/tonsillitis (alternative agent): Oral: 7.5 mg/kg/dose (maximum: 250 mg/dose) every 12 hours for 10 days (IDSA [Shulman 2012]). Pneumonia, community-acquired: Infants >3 months and Children: Oral: Note: A beta-lactam antibiotic should be added if typical bacterial pneumonia cannot be ruled out. Presumed atypical (M. pneumoniae, C. pneumoniae, C. trachomatis) infection, mild-to-severe atypical infection or step-down therapy (alternative to azithromycin): 7.5 mg/kg/dose (maximum dose: 500 mg) every 12 hours (Bradley 2011) Prophylaxis against infective endocarditis (off-label use): Children and Adolescents: Oral: 15 mg/kg/dose (maximum: 500 mg/dose) 30-60 minutes before procedure (maximum: 500 mg). Note: American Heart Association (AHA) guidelines now recommend prophylaxis only in patients undergoing invasive procedures and in whom underlying cardiac conditions may predispose to a higher risk of adverse outcomes should infection occur. As of April 2007, routine prophylaxis for GI/GU procedures is no longer recommended by the AHA (Wilson 2007). Sinusitis: Infants ≥6 months, Chil

Refer to adult dosing.

CrCl ≥30 mL/minute: No dosage adjustment necessary. CrCl Hemodialysis: Administer after HD session is completed (Aronoff 2007). In combination with atazanavir or ritonavir: CrCl 30 to 60 mL/minute: Decrease clarithromycin dose by 50%. CrCl

No dosage adjustment necessary if renal function is normal; however, in patients with hepatic impairment and concomitant severe renal impairment, a dosage reduction or prolonged dosing intervals may be appropriate.

Warnings & Precautions

Source: Lexicomp

Altered cardiac conduction

Use has been associated with QT prolongation and infrequent cases of arrhythmias, including torsades de pointes (may be fatal); avoid use in patients with known prolongation of the QT interval, ventricular cardiac arrhythmia (including torsades de pointes), uncorrected hypokalemia or hypomagnesemia, clinically significant bradycardia, and patients receiving Class IA (eg, quinidine, procainamide) or Class III (eg, amiodarone, dofetilide, sotalol) antiarrhythmic agents or other drugs known to prolong the QT interval.

Hepatic effects

Elevated liver function tests and hepatitis (hepatocellular and/or cholestatic with or without jaundice) have been reported; usually reversible after discontinuation of clarithromycin. May lead to hepatic failure or death (rarely), especially in the presence of preexisting diseases and/or concomitant use of medications. Discontinue immediately if symptoms of hepatitis (eg, anorexia, jaundice, abdominal tenderness, pruritus, dark urine) occur.

Hypersensitivity reactions

Severe acute reactions have been reported, including anaphylaxis, Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), drug rash with eosinophilia and systemic symptoms (DRESS), Henoch-Schönlein purpura (IgA vasculitis), and acute generalized exanthematous pustulosis; discontinue therapy and initiate treatment immediately for severe acute hypersensitivity reactions.

Superinfection

Use may result in fungal or bacterial superinfection, including C. difficile-associated diarrhea (CDAD) and pseudomembranous colitis; CDAD has been observed >2 months postantibiotic treatment. Disease-related concerns:

CAD

Use with caution in patients with CAD. A clinical trial in patients with CAD demonstrated an increase in risk of all-cause mortality ≥1 year after the end of treatment in patients randomized to receive clarithromycin. Other epidemiologic studies evaluating this risk have variable results.

Myasthenia gravis

Use with caution in patients with myasthenia gravis; exacerbation of symptoms and new onset of symptoms has occurred.

Renal impairment

Use with caution in severe renal impairment; dosage adjustment required. Concurrent drug therapy issues:

Drug-drug interactions

Potentially significant interactions may exist, requiring dose or frequency adjustment, additional monitoring, and/or selection of alternative therapy. Consult drug interactions database for more detailed information. Special populations:

Elderly

Use with caution; elderly patients may be at increased risk of torsades de pointes.

HIV patients

Decreased survival has been observed in HIV patients with Mycobacterium avium complex (MAC) receiving clarithromycin doses above the maximum recommended dose; maximum recommended dosing should not be exceeded in this population. Development of resistance to clarithromycin has been observed when used as prophylaxis and treatment of MAC infection (Biaxin Canadian product labeling 2016). Dosage form specific issues:

Extended release formulation

The presence of extended release tablets in the stool has been reported, particularly in patients with anatomic (eg, ileostomy, colostomy) or functional GI disorders with decreased transit times. Consider alternative dosage forms (eg, suspension) or an alternative antimicrobial for patients with tablet residue in the stool and no signs of clinical improvement.

Propylene glycol

Some dosage forms may contain propylene glycol; large amounts are potentially toxic and have been associated hyperosmolality, lactic acidosis, seizures, and respiratory depression; use caution (AAP 1997; Zar 2007). Other warnings/precautions:

Appropriate use

Helicobacter pylori eradication: Short-term combination therapy (≤7 days) has been associated with a higher incidence of treatment failure. Current guidelines recommend 10 to 14 days of therapy (triple or quadruple) for eradication of H. pylori in pediatric and adult patients (Chey 2007; NASPHGAN [Koletzko 2011]).

Pregnancy & Lactation

Pregnancy

FDA category C Teratogenic

Caution

Avoid in T1 if possible. Switch to azithromycin or amoxicillin

Lactation

Clarithromycin and its active metabolite (14-hydroxy clarithromycin) are excreted into breast milk. The manufacturer recommends that caution be used if administered to nursing women. Decreased appetite, diarrhea, rash, and somnolence have been noted in nursing infants exposed to macrolide antibiotics (Goldstein 2009).

LactMed: monitor the infant.

Monitoring

Efficacy	Culture and susceptibility testing; clinical resolution (temperature, WBC, CRP, procalcitonin)
Toxicity	Renal function (dose adjustment in renal impairment); hepatic function for hepatically cleared agents; signs of C. difficile infection (diarrhoea)
Clinical pearl	Culture results guide de-escalation to narrower-spectrum therapy. Review antibiotic appropriateness at 48–72 h (antimicrobial stewardship).
Counseling	Complete the full course. Report persistent diarrhoea, rash, or lack of improvement after 48–72 h.

Chemistry & Properties

Formula	C38H69NO13
Molecular weight	747.96 g/mol
IUPAC name	(3R,4S,5S,6R,7R,9R,11R,12R,13S,14R)-6-[(2S,3R,4S,6R)-4-(dimethylamino)-3-hydroxy-6-methyloxan-2-yl]oxy-14-ethyl-12,13-dihydroxy-4-[(2R,4R,5S,6S)-5-hydroxy-4-methoxy-4,6-dimethyloxan-2-yl]oxy-7-methoxy-3,5,7,9,11,13-hexamethyl-oxacyclotetradecane-2,10-dione
CAS	81103-11-9
PubChem CID	84029
InChIKey	`AGOYDEPGAOXOCK-KCBOHYOISA-N`
logP	2.44 (XLogP 3.2)
Polar surface area	182.91 Å²
H-bond acceptors / donors	14 / 4
Drug-likeness (QED)	0.27
Lipinski violations	2

SMILES

CC[C@H]1OC(=O)[C@H](C)[C@@H](O[C@H]2C[C@@](C)(OC)[C@@H](O)[C@H](C)O2)[C@H](C)[C@@H](O[C@@H]2O[C@H](C)C[C@H](N(C)C)[C@H]2O)[C@](C)(OC)C[C@@H](C)C(=O)[C@H](C)[C@@H](O)[C@]1(C)O

Biology & Pharmacokinetics

Pharmacokinetics

BBB penetrant	No

Enzyme interactions

Enzyme	Role	Detail
CYP2B6	Inhibitor	—
CYP2C19	Substrate	—
CYP3A4	Inhibitor	Ki 5.49 µM
CYP3A4	Substrate	—

Transporters

BCRP (Inhibitor)BSEP (Inhibitor)BSEP (Inhibitor)MDR1 (Inhibitor)MRP1 (Inhibitor)MRP2 (Inhibitor)MRP3 (Inhibitor)MRP4 (Inhibitor)OAT2 (Inhibitor)OATP1A2 (Inhibitor)OATP1B1 (Inhibitor)OATP1B1 (Inhibitor)OATP1B3 (Inhibitor)OATP1B3 (Inhibitor)OATP2B1 (Inhibitor)P-gp (Inhibitor)MDR1 (Substrate)NTCP (Substrate)OATP1B1 (Substrate)OATP1B3 (Substrate)OATP2B1 (Substrate)OCT1 (Substrate)P-gp (Substrate)

Drug–drug interactions (100+, DDInter)

Interacting drug	Severity	Management
Abemaciclib	major
Acalabrutinib	major
Alfentanil	major
Alfuzosin	major
Amiodarone	major
Amisulpride	major
Anagrelide	major
Anisindione	major
Arsenic trioxide	major
Artemether	major
Astemizole	major
Atorvastatin	major
Avanafil	major
Avapritinib	major
Axitinib	major
Bedaquiline	major
Benzhydrocodone	major
Bepridil	major
Berotralstat	major
Betrixaban	major
Bosutinib	major
Brexpiprazole	major
Brigatinib	major
Budesonide	major
Butorphanol	major
Cabergoline	major
Cabozantinib	major
Capmatinib	major
Carbamazepine	major
Cariprazine	major
Ceritinib	major
Cerivastatin	major
Chloroquine	major
Cilostazol	major
Cisapride	major
Citalopram	major
Cobimetinib	major
Colchicine	major
Conivaptan	major
Copanlisib	major

Showing 40 of 100+.

Registered Products (48)

Brand	Form / strength	Pack	Agent	Citizen (JOD)
Eracid	Tablet 250 mg	14 tab	THE JORDANIAN PHARMACEUTICAL MANUFACTURING COMPANY/JORDAN	3.670
Claridar Suspension	Suspension 125 mg/5 ml	60 ml pack varies	Dar Al Dawa Development and Investment Co Ltd/Jordan	3.940
Claritop 125mg/	Suspension 125 mg/5 ml	60 ml	AL-RAM PHARMA.INDUS.CO.LTD/JORDAN	3.940
CLARIDAR 250 TABLETS	Tablet 250 mg	14 tab	Dar Al Dawa Development and Investment Co Ltd/Jordan	4.320
Claritop tablet	Tablet 250 mg	14 tab pack varies	AL-RAM PHARMA.INDUS.CO.LTD/JORDAN	4.320
Joclar 250 Caplet	Tablet 250 mg	14 tab	Jordan Sweden Medical & Sterilization Co.	4.320
Klarimid	Tablet 250 mg	14 tab	MIDDLE EAST PHARMA&CHEMICAL IND/JORDAN	4.320
Macromax F.C. Tab	Film-Coated Tablet 250 mg	14 tab	Hayat Pharmaceutical Industries CO.PLC/JORDAN	4.320
Klacid Susp.125	Suspension 125 mg/5 ml	60 ml pack varies	Abu Sheikha Drug Store	4.500
Klarimid 125	Suspension 125 mg/5 ml	75 ml pack varies	MIDDLE EAST PHARMA&CHEMICAL IND/JORDAN	4.930
Klacid Tab 250	Tablet 250 mg	14 tab	Abu Sheikha Drug Store	5.110
Klacid Susp.125	Suspension 125 mg/5 ml	100 ml pack varies	Abu Sheikha Drug Store	6.500
Claridar Suspension	Suspension 125 mg/5 ml	100 ml pack varies	Dar Al Dawa Development and Investment Co Ltd/Jordan	6.560
Klarimid Susp	Suspension 125 mg/5 ml	100 ml pack varies	MIDDLE EAST PHARMA&CHEMICAL IND/JORDAN	6.560
Klarimid Susp	Suspension 250 mg/5 ml	75 ml pack varies	MIDDLE EAST PHARMA&CHEMICAL IND/JORDAN	7.820
Claridar Dar Al Dawa XL	Tablet 500 mg	7 tab pack varies	Dar Al Dawa Development and Investment Co Ltd/Jordan	8.120
Claritt XL	Extended-Release Tablet 500 mg	7 E.R.Tab	Sukhtian Group	8.120
Klacid XL	Tablet 500 mg	7 tab pack varies	Abu Sheikha Drug Store	8.910
Claritt	Tablet 500 mg	14 tab	Sukhtian Group	9.560
Claridar Suspension	Suspension 250 mg/5 ml	100 ml	Dar Al Dawa Development and Investment Co Ltd/Jordan	9.570
Clamycin 500mg F.C Tab	Film-Coated Tablet 500 mg	14 tab	Professional Drug Store	9.590
Klamed	Tablet 500 mg	14 tab	Khoury Drug Store	10.420
Klarimid Susp	Suspension 250 mg/5 ml	100 ml pack varies	MIDDLE EAST PHARMA&CHEMICAL IND/JORDAN	10.430
Joclar 500 Tab	Tablet 500 mg	14 Caplet pack varies	Jordan Sweden Medical & Sterilization Co.	11.250
Klacid Susp.	Suspension 250 mg/5 ml	100 ml	Abu Sheikha Drug Store	12.200
Claridar TABLETS	Tablet 500 mg	14 tab pack varies	Dar Al Dawa Development and Investment Co Ltd/Jordan	12.290
Claritop	Tablet 500 mg	14 tab pack varies	AL-RAM PHARMA.INDUS.CO.LTD/JORDAN	12.290
Clarix tab	Tablet 500 mg	14 tab pack varies	Pharma International Company/ Jordan	12.290
Eracid	Tablet 500 mg	14 tab	THE JORDANIAN PHARMACEUTICAL MANUFACTURING COMPANY/JORDAN	12.290
Klarilide	Tablet 500 mg	14 tab	UNITED PHARM.MFG.CO.LTD(UPM)/JORDAN	12.290
Klarimid 500	Tablet 500 mg	14 tab pack varies	MIDDLE EAST PHARMA&CHEMICAL IND/JORDAN	12.290
Macromax F.C Tab	Film-Coated Tablet 500 mg	14 tab pack varies	Hayat Pharmaceutical Industries CO.PLC/JORDAN	12.290
Klacid Lyoph.Pow/Vial	Vial 500 mg	1 vial	Abu Sheikha Drug Store	13.030
Klacid Tab	Tablet 500 mg	14 tab pack varies	Abu Sheikha Drug Store	13.660
Claranta	Tablet 500 mg	20 tab	Sahar Drug Store	14.250
Claridar Dar Al Dawa XL	Tablet 500 mg	14 tab pack varies	Dar Al Dawa Development and Investment Co Ltd/Jordan	15.430
Joclar 500 Tab	Tablet 500 mg	20 Caplet pack varies	Jordan Sweden Medical & Sterilization Co.	16.070
Klacid XL	Tablet 500 mg	14 tab pack varies	Abu Sheikha Drug Store	16.930
Claridar TABLETS	Tablet 500 mg	20 tab pack varies	Dar Al Dawa Development and Investment Co Ltd/Jordan	17.560
Claritop	Tablet 500 mg	20 tab pack varies	AL-RAM PHARMA.INDUS.CO.LTD/JORDAN	17.560
Clarix tab	Tablet 500 mg	20 tab pack varies	Pharma International Company/ Jordan	17.560
Klarimid 500	Tablet 500 mg	20 tab pack varies	MIDDLE EAST PHARMA&CHEMICAL IND/JORDAN	17.560
Macromax F.C Tab	Film-Coated Tablet 500 mg	20 tab pack varies	Hayat Pharmaceutical Industries CO.PLC/JORDAN	17.560
Klacid Tab	Tablet 500 mg	20 tab pack varies	Abu Sheikha Drug Store	19.510
Claritop	Tablet 250 mg	700 tab pack varies	AL-RAM PHARMA.INDUS.CO.LTD/JORDAN	183.600
Clarix tab	Tablet 500 mg	350 tab pack varies	Pharma International Company/ Jordan	261.160
Clarix tab	Tablet 500 mg	700 tab pack varies	Pharma International Company/ Jordan	522.330
Claritop	Tablet 500 mg	1000 tab pack varies	AL-RAM PHARMA.INDUS.CO.LTD/JORDAN	741.050