Bicrolid

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Medically reviewed

Rosario Oropesa

Last updated on 22/12/2025

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Bicrolid

Quick Facts

Feature Detail
Active Ingredient Clarithromycin
Pharmacological Class Macrolide Antibiotic
Status Prescription Only (Rx)
Distinction Semi-synthetic derivative of erythromycin

Bicrolid is a brand name for the prescription-only medication whose active ingredient is clarithromycin, a drug belonging to the macrolide class of antibiotics. It is prescribed by healthcare providers to treat a variety of infections caused by susceptible bacteria. Clarithromycin works by stopping the growth of bacteria, making it effective for mild-to-moderate bacterial infections in different parts of the body, particularly the respiratory system.

Core Identity and Applications

Clarithromycin is distinguished as a semi-synthetic derivative of the older antibiotic erythromycin. This modification enhances its absorption, allows for less frequent dosing, and provides broader activity against certain bacteria. Its efficacy is clinically recognized for treating common community-acquired bacterial respiratory infections, such as certain types of pneumonia and bronchitis.

Bicrolid is typically formulated as tablets, with both immediate-release and extended-release versions available, which offer different dosing schedules. A key application where clarithromycin is commonly employed is in combination with other medications to eradicate the bacterium Helicobacter pylori, which is a known cause of peptic ulcers.

It is essential to note that Bicrolid, like all antibiotics, is effective only against bacterial infections and will not treat infections caused by viruses, such as the common cold or flu. The decision to use this medication is based on a healthcare professional's assessment of the specific infection type and the susceptibility of the causative bacteria.

Regulatory References

  1. Clarithromycin: MedlinePlus Drug Information

What side effects are possible with Bicrolid?

Possible Side Effects and Safety Information

The official safety profile for Bicrolid, which contains clarithromycin, is structured around frequency-classified adverse reactions and specific constraints documented by governmental regulatory authorities (e.g., FDA, EMA). Adverse reactions are categorized by the physiological system affected.

Common Adverse Reactions

The most frequently reported adverse reactions affect the Gastrointestinal Disorders and Nervous System Disorders organ classes. These commonly include diarrhea, abdominal pain, nausea, vomiting, and dysgeusia (altered taste). Headache and insomnia are also classified as common [FDA Label, SmPC].

Serious Adverse Reactions

The regulatory safety profile highlights risks of serious adverse reactions, which are officially documented but occur infrequently. These include potentially severe Hepatobiliary Disorders, such as fatal hepatic failure, which has been reported, often in patients with pre-existing conditions. The medication has also been associated with QT prolongation and ventricular arrhythmia, including Torsades de pointes, a serious cardiac rhythm problem. Severe skin reactions, such as Stevens-Johnson Syndrome (SJS), are explicitly listed [FDA Label, SmPC].

Population-Specific Safety Constraints

Specific safety considerations are defined for certain populations and conditions. An increased long-term risk of death (cardiovascular) has been observed in patients with pre-existing Coronary Artery Disease (CAD) following a standard course of treatment, a safety note added by regulatory bodies. Clarithromycin is contraindicated in patients with a history of severe hepatic failure combined with renal impairment, and dosage adjustment is required for patients with severe renal impairment (CrCl < 30 mL/min). The potential for Clostridium difficile-associated diarrhea (CDAD) is noted, with symptoms possibly appearing up to two months after treatment cessation [FDA Safety Communication, SmPC].

Overdose and Emergency Response

Overdose and When to Seek Help

The following information details the officially documented manifestations and required emergency procedures for Bicrolid (Clarithromycin) overdose, based on government regulatory labeling.

Documented Manifestations and Risks

Feature Regulatory Documentation Summary
Physical Presentation Acute overdose is primarily documented to cause severe gastrointestinal symptoms, including abdominal pain, vomiting, nausea, and diarrhea. Transient hearing loss has also been observed.
Serious Systemic Risk Official labels highlight the risk of severe cardiac events, specifically QT prolongation and potentially life-threatening Torsade de pointes. Cases of severe hepatic dysfunction have also been documented.
Population Note The elderly and patients with pre-existing renal or hepatic impairment are noted to have an increased risk of specific toxicities in the context of overdose.

Required Emergency Actions

Immediate medical attention is required for any suspected overdose, even if symptoms are not yet apparent. Individuals should contact a Poison Control Center or healthcare professional immediately. Emergency services must be contacted if the person has collapsed, had a seizure, has trouble breathing, or cannot be awakened.

Management procedures described in official documents are limited to symptomatic and supportive measures and the prompt elimination of unabsorbed drug.

There is no specific antidote known for Clarithromycin overdose, and the substance is not appreciably removed by hemodialysis.

Therapeutic Uses of Bicrolid

What Bicrolid treats: main uses and benefits

Bicrolid is a macrolide antibiotic containing the active substance clarithromycin. It is designed to inhibit the growth of specific types of bacteria by interfering with their protein synthesis, which prevents the bacteria from multiplying and allows the body's immune system to clear the infection.

Respiratory Tract Infections

Bicrolid is frequently used to treat infections affecting both the upper and lower respiratory systems. These conditions include:

  • Pharyngitis and Tonsillitis: Inflammation of the throat or tonsils caused by bacterial pathogens.
  • Sinusitis: Bacterial infection of the nasal sinuses.
  • Acute Bronchitis: Bacterial exacerbations of long-term lung conditions or new-onset bronchial infections.
  • Pneumonia: Community-acquired pneumonia caused by susceptible organisms, such as Streptococcus pneumoniae or Mycoplasma pneumoniae.

Skin and Soft Tissue Infections

Bicrolid is effective against various bacterial infections of the skin and underlying tissues. It is commonly prescribed for:

  • Folliculitis: Infection of the hair follicles.
  • Cellulitis: A deep bacterial skin infection.
  • Erysipelas: A specific type of superficial skin infection characterized by clear boundaries.

Helicobacter pylori Eradication

In patients with gastrointestinal issues, Bicrolid is often used as part of a combination therapy to eliminate Helicobacter pylori. This bacterium is a primary cause of duodenal and gastric ulcers. By eradicating the bacteria, the medication helps reduce the risk of ulcer recurrence and promotes the healing of the stomach lining.

Mycobacterial Infections

Bicrolid is also utilized in the treatment and prevention of disseminated infections caused by Mycobacterium avium complex (MAC). These infections are typically seen in individuals with compromised immune systems.

Key Benefits

  • Broad-Spectrum Activity: It is effective against a wide range of aerobic and anaerobic Gram-positive and Gram-negative bacteria.
  • Tissue Penetration: The medication achieves high concentrations in the tissues, particularly in the lungs and skin, which aids in targeting the site of infection directly.
  • Acid Stability: Unlike some earlier antibiotics in its class, the active ingredient is stable in gastric acid, which allows for efficient absorption in the digestive tract.

Regulatory References

  1. NIH MedlinePlus Drug Information

Eligibility and Restrictions for Use

Eligibility Map: Who Can and Cannot Use Bicrolid — Official Regulatory Information

Bicrolid (Clarithromycin) is subject to strict eligibility rules documented in official government prescribing information, which define approved populations and absolute exclusions.

Populations for whom use is contraindicated: Criterion Exclusionary Condition
Allergy Known hypersensitivity to any macrolide antibiotic drug.
Organ Failure Severe hepatic failure combined with renal impairment.
Cardiac Risk History of QT prolongation, ventricular arrhythmia, or existing hypokalaemia.

Age-Related Eligibility Rules: The tablet formulation is generally approved for adults and adolescents (aged 12 years and older). Children between 6 months and 12 years must use the pediatric oral suspension formulation, as the tablets are not recommended for this age group. Use in infants under 6 months is supported by limited data.

Pregnancy and Lactation Eligibility Status: Use in pregnant women is generally not recommended, especially in the first trimester, and should only occur if the benefits are deemed to outweigh the risks. The safety in breastfeeding infants has not been established, as the drug is excreted into breast milk.

Condition-Specific Eligibility Restrictions: Patients with severe renal impairment (creatinine clearance <30 mL/min) require use to be restricted with a mandatory dosage reduction. Caution is also advised in patients with existing impaired hepatic function and certain cardiovascular conditions (e.g., severe cardiac insufficiency).

What should I know about interactions with other medicines?

Bicrolid (Clarithromycin) interactions are defined by its effect on key metabolic and transport systems. Official regulatory documentation classifies these interactions based on the risk of increased drug exposure and toxicity, resulting in specific restrictions and prohibitions.


Formal Contraindicated Combinations

Regulatory bodies strictly prohibit co-administration of Bicrolid with specific medicinal products due to the risk of severe adverse reactions, which often result from elevated drug plasma concentrations. Prohibited combinations include:

  • Statins: Lovastatin and Simvastatin (risk of muscle damage).
  • Ergot Alkaloids: Ergotamine and Dihydroergotamine (risk of acute vasospasm).
  • Other Drugs: Pimozide, Cisapride, and Lurasidone (risk of serious cardiac arrhythmias).

Clinically Significant Pharmacokinetic Interactions

Bicrolid is documented as an inhibitor of the CYP3A4 metabolic enzyme and the P-glycoprotein (P-gp) transport protein. This inhibition leads to increased systemic exposure of many co-administered drugs, including Digoxin, Carbamazepine, Theophylline, and immunosuppressants such as Cyclosporine.

Conversely, co-administration with CYP3A4 inducers, such as Rifampin, significantly decreases the plasma concentration of Bicrolid itself.


Administration Restrictions and Special Cautions

For some interactions, mandatory timing rules apply: The dose of Zidovudine must be separated from the dose of Bicrolid by at least two hours. A population-specific restriction notes that the prohibition against taking Bicrolid with Colchicine is explicitly for patients with pre-existing renal or hepatic impairment.

Mechanism of Action

Targeting the Bacterial Protein Synthesis Pathway

This domain covers the drug's core action as an inhibitor by binding to the bacterial 50S ribosomal subunit. The drug's physical presence blocks the process of translocation, which is essential for bacteria to elongate and complete necessary protein chains. This mechanism results in the functional arrest of microbial proliferation (bacteriostasis), resulting in a functional reduction of microbial activity.


Modulation of Host Inflammatory Signals

This secondary domain describes the drug's activity within the host's immune cells, specifically phagocytes, where it modulates the intracellular pathways responsible for generating pro-inflammatory chemical messengers. This mechanism directly suppresses the excessive release of cytokines (e.g., IL-6 and TNF-alpha), modulating inflammatory signaling dynamics at the cellular level.


Mechanistic Resilience and Limitation

This domain addresses the boundaries of the drug's effect, focusing on bacterial resistance mechanisms and target specificity. Resistance pathways, such as ribosomal methylation and the activation of efflux pumps, structurally or functionally override the drug's inhibitory action. This boundary defines the specific requirements of the mechanism, which is confined to organisms possessing the susceptible 50S ribosomal structure.

Dosage and Administration Information

Bicrolid (clarithromycin) is primarily administered orally using immediate-release (IR) tablets, extended-release (ER) tablets, or a reconstituted oral suspension. An intravenous (IV) form is also approved, but it is typically reserved for acute, limited use (2 to 5 days) in patients unable to take oral medication, followed by a transition to the oral route.

Dosing and Frequency Patterns

The dosage frequency is directly dependent on the formulation. The IR forms are generally prescribed for administration twice daily (every 12 hours), while the ER tablets are designed for a once-daily regimen, commonly as a 1000 mg dose.

Specific consumption rules must be followed for certain forms. IR tablets and the oral suspension may be taken with or without food. Conversely, the ER tablets must be taken with food to ensure proper absorption and must be swallowed whole without crushing or breaking to preserve the extended-release characteristics.

Duration and Adjustments

Treatment duration typically ranges from 7 to 14 days for acute infections, though a minimum course of at least 10 days is required for infections caused by Streptococcus pyogenes. For adult patients with severe renal impairment (creatinine clearance < 30 mL/min), the total daily dose is reduced by one-half. Pediatric dosing utilizes the oral suspension and is calculated based on a weight-based regimen. If a dose is missed, it should be taken as soon as possible unless it is nearly time for the next dose, in which case the missed dose is skipped; doubling the dose is forbidden.

Recent Clinical Evidence

Research evidence / Overview of studies for Bicrolid

Evidence for Common Community-Acquired Infections

Short-term Randomized Controlled Trials (RCTs) have examined Bicrolid for treating common conditions such as community-acquired pneumonia, acute bronchitis, and skin infections. These studies monitored outcomes related to clinical cure and bacteriological eradication in comparison to other antibiotics. Research describes the challenge presented by emerging macrolide resistance, which influences the interpretation of findings from older studies.


Evidence for Specialized Infection Management

Bicrolid was evaluated in complex multi-drug regimens, particularly for eradicating Helicobacter pylori in ulcer patients and managing Mycobacterium avium complex (MAC) disease in specialized patient groups. Findings indicate that success rates for H. pylori eradication are highly dependent on the local prevalence of Bicrolid resistance. For MAC disease, evidence is limited outside of its use as a component of multi-drug regimens, and potential for resistance to emerge is a factor monitored in research.


Long-Term Studies and Extended Follow-up

Research has explored outcomes observed in patients years after they completed a short course of Bicrolid, particularly those treated for respiratory infections. These observational cohort studies tracked patterns related to all-cause mortality. The results were observed to be mixed across different studies. Certainty remains low regarding the established effect of these extended-duration findings, as observational study designs are limited in their ability to establish causation.


Research in Specific Patient Groups and Evidence Gaps

Clinical trials have monitored outcomes in pediatric patients (children aged 6 months to 12 years) and immunocompromised individuals. However, data for certain groups remain insufficient, and there is limited information for children under six months of age. Overall, the research highlights that the inconsistency of long-term findings and the increasing prevalence of antibiotic resistance are key areas of ongoing scientific uncertainty.

Key Studies & References

  1. Clarithromycin Official Drug Label/Prescribing Information (Biaxin)
  2. Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV (MAC Disease)

Frequently Asked Questions (FAQ)

Common questions about Bicrolid (FAQ)

Q: How quickly can a person expect to start feeling better after beginning Bicrolid?

Clinical experience indicates that most people start to notice improvement in their condition within a few days of beginning treatment with Bicrolid. It is described in official patient information that the medication begins working early in the treatment course, but it is important that the full prescribed course be completed.

Q: What happens if a person stops taking Bicrolid before the entire prescribed course is finished?

Stopping the medication too early has the potential for the infection to return because not all bacteria may have been eliminated. Official guidance stresses the importance of completing the full prescribed course to reduce the development of drug-resistant bacteria.

Q: What is the risk of developing antibiotic resistance when using Bicrolid?

According to regulatory guidance, this medication should only be used for infections proven or strongly suspected to be bacterial. Following this guidance is intended to help reduce the development of drug-resistant bacteria and ensures the medication maintains its effectiveness over time.

Q: Are there long-term health risks associated with taking Bicrolid, particularly for those with heart conditions?

Official safety communications have noted a potential increased long-term risk of cardiovascular death observed in patients with pre-existing Coronary Artery Disease (CAD). This observation is included in the medication’s safety profile reviewed by regulatory bodies.

Q: Is it safe to crush or split Bicrolid tablets to make them easier to swallow?

Extended-release (ER) tablets must be swallowed whole and should not be broken, crushed, or chewed. This requirement ensures the proper, gradual absorption of the medication over time as it was formulated to do. The extended-release (ER) form should not be altered, as this ensures the drug functions as intended.

Q: Is Bicrolid generally safe for use in children and at what ages is it typically prescribed?

The official prescribing information notes that the safety and efficacy of this medication for treating bacterial infections have not been established for children younger than 6 months of age. Use in older children is typically based on a weight-based regimen using the oral suspension formulation.

Q: Does Bicrolid interact with alcohol or affect how it is processed by the body?

Official governmental health service monographs indicate that there is no specific warning or recommendation to avoid consuming alcohol while taking Bicrolid. Patients should review all substances, including alcohol, with the prescribing healthcare professional.

Q: What should a person do if they notice their eyes or skin turning yellow while taking Bicrolid?

Signs like yellowing of the skin or eyes (jaundice), dark urine, or pain in the upper abdomen can indicate a serious liver problem. According to regulatory warnings, if any signs of hepatic (liver) failure occur, the medication's official warnings indicate it should be discontinued.

Q: Why is caution advised when prescribing Bicrolid to people with a history of myasthenia gravis?

Regulatory warnings indicate that the medication may cause an exacerbation (worsening) of symptoms in people who have Myasthenia Gravis. This condition is characterized by severe muscle weakness, and this potential adverse event is specifically noted in the official product information.

Q: Is the metallic or bitter taste a common side effect of Bicrolid?

Official product labeling lists an altered sense of taste, medically known as dysgeusia, as one of the most frequently reported side effects. This taste alteration is often described by patients as metallic or bitter.

Q: Can Bicrolid cause changes in sleep patterns or unusual dreams?

Official safety data includes reports of adverse reactions that may affect sleep. Insomnia (difficulty sleeping) is reported as a common reaction, while feelings of confusion and the occurrence of nightmares have also been reported, though less frequently.

Q: Is hearing loss a possible side effect of Bicrolid use?

Hearing impairment and tinnitus (ringing or buzzing in the ears) are reported adverse reactions associated with this drug. Regulatory information notes that cases of hearing loss have sometimes been transient (temporary) when the medication was administered at high doses.

Q: How long after finishing the course can side effects from Bicrolid last?

Common and mild side effects typically resolve within a few days or a couple of weeks after the medication is stopped. However, a serious intestinal problem called Clostridioides difficile-associated diarrhea (CDAD) is noted in regulatory documents as potentially occurring up to two months or more after the end of treatment.

Q: What specific blood tests might be monitored while a person is on Bicrolid?

Since the drug carries a risk of liver dysfunction, blood tests that measure markers like liver enzymes (such as alkaline phosphatase or blood bilirubin) may be monitored. An increase in these markers is listed in the official adverse reactions documentation.

Q: What is the difference between the immediate-release and extended-release formulations of Bicrolid?

The difference lies in the absorption rate: Immediate-release tablets are designed to be rapidly absorbed into the body. Extended-release tablets are specially formulated to provide a gradual, prolonged absorption of the medicine over a longer period of time.

Q: Is it common for people to report ringing in the ears while taking Bicrolid?

Tinnitus (ringing or buzzing in the ears) is listed as an adverse reaction in the official regulatory documentation for this medication. This symptom is sometimes reported in conjunction with hearing impairment.

Q: What is the concern about low magnesium or potassium levels when taking Bicrolid?

Low levels of electrolytes like magnesium or potassium (known as hypomagnesemia or hypokalemia) can increase the risk of serious heart rhythm problems when taking this drug. Regulatory guidance states that the medication should be avoided in patients with uncorrected deficiencies in these electrolytes.

Q: Why does my medicine label say Bicrolid is a macrolide?

The medicine's label identifies it as a macrolide antibiotic because this is its formal classification under drug regulatory standards. Macrolides work by inhibiting the growth of bacteria, and this classification is a required identifier on official product information.

Q: Is it normal to feel more tired while on a course of Bicrolid?

Official regulatory documents list fatigue and malaise as reported adverse reactions. Malaise refers to a general feeling of discomfort or unease that may accompany the use of the medication.

Q: If Bicrolid did not work for a past infection, can it still be used for a different one?

The effectiveness of Bicrolid is dependent on the specific bacteria causing the infection being susceptible (not resistant) to the drug. If a previous infection failed to respond due to bacterial resistance, official guidance indicates that alternative non-macrolide therapies may be considered for future infections.

How should Bicrolid be stored and disposed of?

How to Store and Dispose of Bicrolid (Clarithromycin)

The official storage conditions for Bicrolid (Clarithromycin) are defined by the specific formulation. Tablets must be stored at room temperature, typically 20 C to 25 C, and protected from light and moisture. All forms must be kept in the original container, which must be tightly closed, and stored out of the reach of children.

Stability and Disposal

Formulation Required Storage Condition Stability Limit
Tablets 20 C to 25 C N/A
Oral Suspension (Mixed) 15 C to 30 C, Do not refrigerate Use within 14 days of mixing

Expired or unused Clarithromycin must be thrown away according to local regulations and established guidelines for safe disposal, such as those published by the FDA. The medication must not be flushed down a toilet or sink.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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