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This question was answered on Mon 23, Nov 2009 01:10am by Dr. A. Srivastava
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Antibiotics



    
Asked by catmal1977 (Male; 32; Healthy ) on Sun 22, Nov 2009 11:36pm

Dear Dr. Srivastava. Many thanks for your reply. Does the information you provided in your reply (hereunder)still remains valid for the Klacid XL antibiotics which the box says they are 500mg (Modified release tablets)? Many thanks.Dr. Srivastava wrote Hello,Thank you again for showing faith on this forum. I appreciate your query now that thoroughly explaining your doubt. The answer I wrote earlier was also in same context that "if your wife becomes pregnant and even then you are on medication. It will not at all harm upcoming baby pregnancy since clarithromycin does not appear in semen or affect semens quality by any mean". Firstly, because clarithromycin has a rapid first pass hepatic (liver) metabolism and it is mainly excreted through bile (ultimately in stool) and partly in urine. Secondly, if there is any amount of metabolites present in your urine and body secretion would be insignificant to cause any harmful effect to forthcoming fetus. Thirdly, any major male mediated teratogenic effects (harmful effect to baby from father's medication) is only possible when there is any change in genes of the sperm of father since only the nuclei (gene portion) of sperm contributes to the fetus therefore for any harmful effect of some drug, the genes mutation is required which may not be drastically possible in short term or single course of any antibiotics including clarithromycin. Though there are some suspected drugs (excluding clarithromycin and other commonly used antibiotics) which may have some effect on sperm's motility and viability in rare cases but genetic make-up remains unchanged and that also are under researches to finally prove their effect. Therefore you may continue your medicine course as prescribed until your doctor makes a comment in this regard. Hope this helps. Do keep us posted in case of any further doubts or feedbacks. Take care.

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Answer by Dr. A. Srivastava (doctor) on Mon 23, Nov 2009 01:10am:

Hello once again, It hardly matters that you have taken its generic or modified sustained release form. If the drug does not appear in semen then there is no chance that it can affect your baby. Sustained (modified) release medicines are the same medicine impregnated on resins to prevent its destruction by stomach acid. There is no other role of resin in modified release tablets like changing the chemical form of Klacid XL etc. So don’t worry, your child will not be having any adverse effect since Clarithromycin (Klacid XL) taken by you is completely safe. Hope this helps. Take care & Regards.
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Response by Dr Bhupinder K, MD on Mon 23, Nov 2009 03:15am:
Hello, Welcome to the AMD forum of doctors. Clarithromycin is a category C drug which means that animal studies has shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks. Moreover Dr Anurag has explained very nicely the role of genes in causing any congenital or teratogenic effect on the fetus. Semen is NOT the mode of excretion of Clarithromycin and taking any form of this drug will not cause any genetic changes or changes in the sperm. Rest your wife can go in for regular antenatal checkups which can detect any congenital deformity right from the first trimester. This will allay all your fears. I sincerely hope it helps. Take care and wishing you a very happy and healthy life.

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