The usual alternative when penicillin cannot be used — with a longer interaction list than most antibiotics.
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Clarithromycin is a macrolide antibiotic. It stops bacteria producing the proteins they need to survive.
Its main role in UK practice is as the standard alternative when penicillin cannot be used, and as cover for the atypical bacteria — Mycoplasma, Legionella, Chlamydophila — that penicillins do not touch and that cause a meaningful share of pneumonias.
It is also part of the combination used to eradicate Helicobacter pylori.
Usually 250 to 500mg twice daily, for five to seven days. It can be taken with or without food, though food reduces stomach upset.
A modified-release once-daily preparation exists. Liquid is available for children, dosed by weight.
In pregnancy, erythromycin is generally preferred where a macrolide is needed.
Clarithromycin blocks a major drug-metabolising enzyme, so it raises the levels of a considerable number of medicines. This is the practical reason it needs a proper medicines check rather than a quick prescription.
No routine monitoring for a short course in someone on no other medicines. Where interactions apply, monitoring is arranged accordingly.
Yes, where a bacterial infection is genuinely likely and penicillin is unsuitable.
Before prescribing it we would want to check two things properly. First, whether an antibiotic is needed at all — most coughs and sore throats are viral. Second, your full medicine list, because clarithromycin interacts with more common medicines than most antibiotics, and some of those interactions matter.
Statins in particular need pausing during a course, and that is easily missed if nobody asks.
Clarithromycin is an inexpensive generic. A standard private course usually costs less than the England NHS prescription charge.
The liquid form for children costs more and needs refrigeration once made up.
Complete the course. Stopping early because symptoms improved is stopping while the drug is still finishing the job.
If a reported penicillin allergy is what put you on clarithromycin, it is worth checking whether the allergy is real — around nine in ten labels are not confirmed on testing.
A bitter or metallic taste is a well-recognised effect and settles within days of finishing. It is not a sign of anything going wrong.
Ask before starting. Simvastatin must not be taken with it, and atorvastatin is usually paused for the course. This is one of the few genuinely important antibiotic interactions.
Erythromycin is usually preferred. Tell us if there is any chance you are pregnant.
Alcohol does not stop clarithromycin working, though it may worsen the nausea. That is different from metronidazole, which genuinely must not be combined with alcohol.
Probably — and it is worth getting the label checked. Most childhood penicillin allergy labels turn out to be wrong, and carrying one for life pushes you onto broader antibiotics with more interactions.
Clinically reviewed by Dr Mohammad Zubair Khan, GMC 7563469
Last reviewed
August 30, 2026
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It means the diagnosis can usually be made from your history and photographs, and that treatment can be arranged safely without examining you. Where a condition is not marked treatable online, it is because examination is the diagnosis — listening to a chest, feeling an abdomen, examining an ear or a joint — or because a procedure or device is needed.
Yes, where there is a genuine bacterial infection — cellulitis, impetigo, bacterial urine infections, confirmed strep throat. We will also frequently tell you that you do not need one. Most sore throats, coughs, colds and earaches are viral, and an antibiotic gives you the side effects with none of the benefit.
If your problem turns out to be genuinely outside what we can do remotely, the doctor will tell you straight away, point you to the right service, and refund your fee in full. We would rather do that than fill twenty minutes to justify the charge.
Call 999 or go to A&E — do not book an online appointment and do not wait for a reply to an email. For urgent problems that are not emergencies, NHS 111 is available 24 hours a day, online or by phone, and can direct you to the right service.
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