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Clarithromycin is principally excreted via the liver and kidney. Clarithromycin may be administered without dosage adjustment to patients with hepatic impairment and normal renal function. However, in the presence of severe renal impairment with or without coexisting hepatic impairment, decreased dosage or prolonged dosing intervals may be appropriate. Clarithromycin in combination with ranitidine bismuth citrate therapy is not recommended in patients with creatinine clearance less than 25 mL/min. (See DOSAGE AND ADMINISTRATION.) Clarithromycin in combination with ranitidine bismuth citrate should not be used in patients with a history of acute porphyria. Text Continues Below

For information about precautions of other drugs indicated in combination with BIAXIN, refer to the PRECAUTIONS section of their package inserts.
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