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Clarithromycin

Prescription
Macrolide Antibiotic
Last reviewed 21 Apr 2026 · PetCare.AI Editorial Team
Species
Dog, Cat
Brands
1 available
Interactions
4 documented
Formulations
3

Mechanism of action

Semisynthetic macrolide that binds 50S ribosomal subunit inhibiting protein synthesis. Better acid stability than erythromycin. Active against Mycobacterium, Helicobacter, Bartonella, and atypical organisms.

At a glance

Class
Macrolide Antibiotic
Schedule
Prescription
Storage
Store at room temperature; suspension — do not refrigerate, use within 14 days

Dosing

🐕

Dog

Used for mycobacterial infections, Helicobacter (triple therapy), and Bartonella
Dose
5–10 mg/kg
Route
PO
Frequency
q12h
🐈

Cat

Used for feline mycobacterial infections, Bartonella, and Helicobacter
Dose
7.5 mg/kg
Route
PO
Frequency
q12h

Formulations

💊

Other — 3

Strength
—
Strength
—
Strength
—

Storage

Store at room temperature; suspension — do not refrigerate, use within 14 days

Safety

Monitoring parameters

GI toleranceHepatic enzymes with prolonged useDrug interaction review

Interactions

Contraindicated — 1

Cisapride
contraindicated
Clarithromycin potently inhibits CYP3A4 metabolism of cisapride, causing dangerous QT prolongation and torsades de pointes.
Management: NEVER combine. Use metoclopramide as alternative prokinetic.

Major — 2

Cyclosporine (Systemic)
major
Clarithromycin potently inhibits CYP3A4, increasing cyclosporine levels 2-3 fold. More potent CYP inhibitor than azithromycin.
Management: Avoid if possible. If needed, reduce cyclosporine dose by 50% and monitor trough levels closely.
Colchicine
major
Clarithromycin potently inhibits CYP3A4 and P-glycoprotein, causing dangerous colchicine accumulation. Fatal interactions documented in humans.
Management: Avoid. Use alternative antibiotic. If essential, reduce colchicine dose significantly and monitor CBC.

Moderate — 1

Digoxin
moderate
Clarithromycin inhibits P-glycoprotein and may alter gut flora that inactivates digoxin, increasing digoxin levels by 50-100%.
Management: Monitor digoxin levels. Consider reducing digoxin dose by 25-50% during clarithromycin course.

Brands

Other markets

Biaxin

FAQs

Frequently asked questions

›What is Clarithromycin?
Clarithromycin is a macrolide antibiotic used in pets. Semisynthetic macrolide that binds 50S ribosomal subunit inhibiting protein synthesis. Better acid stability than erythromycin. Active against Mycobacterium, Helicobacter, Bartonella, and atypical organisms.
›What is Clarithromycin used for in pets?
Clarithromycin is used in veterinary medicine for: Used for mycobacterial infections, Helicobacter (triple therapy), and Bartonella; Used for feline mycobacterial infections, Bartonella, and Helicobacter.
›What is the Clarithromycin dose for dogs?
For dogs, Clarithromycin is typically dosed as follows — Used for mycobacterial infections, Helicobacter (triple therapy), and Bartonella: 5–10 mg/kg PO q12h. Always consult your veterinarian for a dose tailored to your pet's weight, age, and condition.
›What is the Clarithromycin dose for cats?
For cats, Clarithromycin is typically dosed as follows — Used for feline mycobacterial infections, Bartonella, and Helicobacter: 7.5 mg/kg PO q12h. Always consult your veterinarian for a dose tailored to your pet's weight, age, and condition.
›Does Clarithromycin need a prescription?
Yes. Clarithromycin is a prescription medication and should only be administered under veterinary supervision.

References

References

Textbooks & handbooks

  • Plumb, D.C. Plumb's Veterinary Drug Handbook. 10th ed., Wiley-Blackwell, 2023.
  • Vail, D.M., Thamm, D.H., & Liptak, J.M. (eds.). Withrow & MacEwen's Small Animal Clinical Oncology. 6th ed., Saunders/Elsevier, 2020.
  • Riviere, J.E., & Papich, M.G. (eds.). Veterinary Pharmacology and Therapeutics. 10th ed., Wiley-Blackwell, 2018.
  • National Research Council. Nutrient Requirements of Dogs and Cats. National Academies Press, Washington DC, 2006.
  • The Merck Veterinary Manual. Merck & Co., Online edition. https://www.merckvetmanual.com/

Clinical guidelines & consensus

  • Fletcher, D.J., Boller, M., Brainard, B.M., et al. "RECOVER Evidence and Knowledge Gap Analysis on Veterinary CPR." Journal of Veterinary Emergency and Critical Care, 2012;22(S1):S102–S131.
  • American Animal Hospital Association. 2018 AAHA Diabetes Management Guidelines for Dogs and Cats. AAHA Press.

Journals & peer-reviewed studies

  • Hogan, D.F., Fox, P.R., Jacob, K., et al. "Secondary prevention of cardiogenic arterial thromboembolism in the cat: The FAT CAT study." Journal of Veterinary Cardiology, 2015;17(Suppl 1):S306–S317.
  • Boswood, A., Häggström, J., Gordon, S.G., et al. "Effect of Pimobendan in Dogs with Preclinical Myxomatous Mitral Valve Disease and Cardiomegaly: The EPIC Study — A Randomized Clinical Trial." Journal of Veterinary Internal Medicine, 2016;30(6):1765–1779.
  • ASPCA Animal Poison Control Center. Toxicology and Poison Management Guidelines. American Society for the Prevention of Cruelty to Animals. https://www.aspca.org/pet-care/animal-poison-control

Regulatory & approvals

  • Central Drugs Standard Control Organisation (CDSCO), Government of India. Veterinary Drug Approval Registry, 1969–2026. Directorate General of Health Services. https://cdsco.gov.in/

Databases

  • Washington State University, College of Veterinary Medicine. Veterinary Clinical Pharmacology Laboratory (VCPL) — MDR1 Multidrug Sensitivity Database. https://vcpl.vetmed.wsu.edu/
Educational reference only
This information is provided for educational purposes and is not a substitute for professional veterinary advice, diagnosis, or treatment. Always consult a qualified veterinarian before administering any medication to your pet. Find a vet near you →

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Azithromycin
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Binds to the 50S ribosomal subunit, inhibiting bacterial protein synthesis
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Erythromycin
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Inhibits bacterial protein synthesis by binding to the 50S ribosomal subunit, preventing translocation. Also has prokinetic effects by acting as a motilin receptor agonist at low doses.
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Tylosin
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Binds to 50S ribosomal subunit, inhibiting bacterial protein synthesis; also has anti-inflammatory and prokinetic properties in the GI tract
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