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Medical Forum / Diseases and Disorders / Sinusitis / January 2007Clarithromycin
A few months ago my Dr put me on Clarithromycin for my sinus problems. This was supposed to be a long term (5 month) process. 500mg twice a day. After two months my pharmasist called to warn me that this antiobiotic will cause hearing loss. Not if,,, it is a matter of time and it will happen. He told me that most Drs aren't aware of this. Is this an issue? > A few months ago my Dr put me on Clarithromycin for my sinus problems. > This was supposed to be a long term (5 month) process. 500mg twice a [quoted text clipped - 3 lines] > > Is this an issue? http://pmj.bmj.com/cgi/content/full/81/951/58 http://www.findarticles.com/p/articles/mi_m0BUM/is_1_82/ai_97754556 http://hearinglosshelp.com/weblog/?p=102 Susan > http://hearinglosshelp.com/weblog/?p=102 I don't know where he got those numbers from. This website doesn't look to be a reliable source, with its scare headlines and books. The guy who wrote that article cited no references, nor did he claim to be an otologist himself. Things like this really worry me: http://hearinglosshelp.com/resources.htm  SignatureSteven D. Litvintchouk Email: sdlitvin@earthlinkNOSPAM.net Remove the NOSPAM before replying to me. >> http://hearinglosshelp.com/weblog/?p=102 > [quoted text clipped - 6 lines] > Things like this really worry me: > http://hearinglosshelp.com/resources.htm Steven, the ototoxic effects of macrolide antibiotics are extremely well known, as I learned from Dr. Grossan and other hearing professionals who used to post on the tinnitus support group. Check Medline if you doubt it. Susan 1: Expert Opin Drug Saf. 2006 May;5(3):383-99.Click here to read Links Understanding drug ototoxicity: molecular insights for prevention and clinical management. * Yorgason JG, * Fayad JN, * Kalinec F. Gonda Department of Cell and Molecular Biology, House Ear Institute, Los Angeles, CA 90057, USA. Ototoxicity is a trait shared by aminoglycoside and macrolide antibiotics, loop diuretics, platinum-based chemotherapeutic agents, some NSAIDs and antimalarial medications. Because their benefits in combating certain life-threatening diseases often outweigh the risks, the use of these ototoxic drugs cannot simply be avoided. In this review, the authors discuss some of the most frequently used ototoxic drugs and what is currently known about the cell and molecular mechanisms underlying their noxious effects. The authors also provide suggestions for the clinical management of ototoxic medications, including ototoxic detection and drug monitoring. Understanding the mechanisms of drug ototoxicity may lead to new strategies for preventing and curing drug-induced hearing loss, as well as developing new pharmacological drugs with less toxic side effects. PMID: 16610968 [PubMed - in process] > A few months ago my Dr put me on Clarithromycin for my sinus problems. > This was supposed to be a long term (5 month) process. 500mg twice a [quoted text clipped - 3 lines] > > Is this an issue? AFAIK, the only evidence for hearing loss is a few isolated case reports, not a significant percentage of all the zillions of patients who take the drug. There are other, equally distressing side effects that are more common, so you might as well worry about those other possible side effects first. :-) SignatureSteven D. Litvintchouk Email: sdlitvin@earthlinkNOSPAM.net Remove the NOSPAM before replying to me. The usual treatment with macrolides long term is with very low dose macrolides: the classic dose of biaxin/clarithromycin is 250 mg day. (Per Ander's Cervin, also referenced in the Chest article.) I have an issue with a pharmacist warning direct to a patient without involving the MD in the discussion. Often pharmacists have various computer programs that will alert them to drug interactions and potential side effects. This can be very helpful. However, ototoxicity is dose dependent, and very rare with oral mycin drugs. Your pharmacist should have discussed with BOTH you and your physician. I've been on low dose biaxin for 5 years with a dramatic decrease in sinusitis. I do have an otologist for vertigo, and he checks my hearing, and it has never been effected. Talk to your doctor and have him/her discuss this with the pharmacist. Here's the Chest article on low dose macrolides: http://www.chestjournal.org/cgi/content/full/125/2_suppl/52S?maxtoshow=&HITS=10& hits=10&RESULTFORMAT=&fulltext=macrolides&searchid=1&FIRSTINDEX=0&sortspec=relev ance&resourcetype=HWCIT Here's an article on a 28 day course: no concerns of ototoxicity http://www.pslgroup.com/dg/15e836.htm Again, discuss this with your doctor. Pharmacists can be invaluable, but they shouldn't operate without the clinical input of the prescribing MD. Judy > > A few months ago my Dr put me on Clarithromycin for my sinus problems. > > This was supposed to be a long term (5 month) process. 500mg twice a [quoted text clipped - 16 lines] > Email: sdlitvin@earthlinkNOSPAM.net > Remove the NOSPAM before replying to me. Actually,,,, I am glad that he did call me. He was just doing his job. After all he is working for me as well. I have no problems with including my Dr in this issue, but I am very pleased that my pharmasist warned me. > The usual treatment with macrolides long term is with very low dose > macrolides: the classic dose of biaxin/clarithromycin is 250 mg day. [quoted text clipped - 39 lines] > > Email: sdlitvin@earthlinkNOSPAM.net > > Remove the NOSPAM before replying to me. On 1/14/07 8:13 AM, in article 1168791219.378510.288980@51g2000cwl.googlegroups.com, "dave" > Actually,,,, I am glad that he did call me. He was just doing his job. > After all he is working for me as well. [quoted text clipped - 46 lines] >>> Email: sdlitvin@earthlinkNOSPAM.net >>> Remove the NOSPAM before replying to me. This subject speaks to one of my "crusades". People should have a single pharmacist that they use consistently, one who knows their situation and often can advise. My son-in-law is a college professor and his pharmacist saved his life by noticing that the new Rx was a duplicate of one he was already taking and the double dose could have been fatal. Medicine, drugs, etc is too complicated today. The PDR can only do so much and frankly when I look for info on the internet I don't always find what I need. Having your own personal pharmacist is just as important as having your own personal physician. By the way, this also can save you money - they may recommend less costly substitutes. Plus they are quick to tune in that the last 3 patients who took this medication complained of awful stomach cramps or whatever. You don't get this from a mail order pharmacy. >On 1/14/07 8:13 AM, in article >1168791219.378510.288980@51g2000cwl.googlegroups.com, "dave" [quoted text clipped - 63 lines] >the last 3 patients who took this medication complained of awful stomach >cramps or whatever. You don't get this from a mail order pharmacy. I live in the US and have found an India pharmacy that does excellent work for me. If I need info on the drugs I get from overseas, I can always google.
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