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However, Equi and collaborators () demonstrated that neither nasal epithelial MDR nor CFTR mRNA levels in adult subjects with CF were changed after 2 weeks of azithromycin treatment, during which time there was a significant improvement in forced exhaled volume in the first second of exhalation (FEV 1).

Erythromycin and clarithromycin are substrates and inhibitors of the 3A isoform subfamily of the cytochrome P450 enzyme system (CYP3A).

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Decrease dose by 50% when coadministered with atazanavir.

In a steady-state study in which healthy elderly subjects (65 years to 81 years of age) were given 500 mg of BIAXIN every 12 hours, the maximum serum concentrations and area under the curves of clarithromycin and 14-OH clarithromycin were increased compared to those achieved in healthy young adults.

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The minimum evaluation of a patient suspected of NTM lung disease should include ( 1) chest radiograph or, in the absence of cavitation, chest HRCT scan; ( 2) three or more sputum specimens for AFB analysis; and ( 3) exclusion of other disorders such as TB and lung malignancy.

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In clinical trials using combination therapy with Lansoprazole plus amoxicillin and clarithromycin, and Lansoprazole plus amoxicillin, no increased laboratory abnormalities particular to these drug combinations were observed.

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CLARICOR (Effect of Clarithromycin on Mortality and Morbidity in Patients with Ischemic Heart Disease trial) was a double blind, placebo controlled trial showing that a two week course of clarithromycin significantly increased cardiovascular and all cause mortality in patients with coronary heart disease but no evidence of respiratory infection.

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Both clarithromycin and itraconazole are substrates and inhibitors of CYP3A, potentially leading to a bi-directional drug interaction when administered concomitantly.

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Furthermore, in the context of this treatment, clarithromycin resistance seems to lead less often to treatment failure (50% v 18.

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Post-marketing reports indicate that coadministration of Clarithromycin with ergotamine or dihydroergotamine has been associated with acute ergot toxicity characterized by vasospasm and ischemia of the extremities and other tissues including the central nervous system.

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To reduce the development of drug-resistant bacteria and maintain the effectiveness of Clarithromycin and other antibacterial drugs, Clarithromycin should be used only to treat or prevent infections that are proven or strongly suspected to be caused by bacteria.

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