Clamelle (Azithromycin)

How does it work?

Clamelle tablets contain the active ingredient azithromycin, which is a type of medicine called a macrolide antibiotic. (NB. Azithromycin is also available without a brand name, ie as the generic medicine.) Azithromycin is used to treat infections caused by bacteria.

Azithromycin works by preventing bacteria from producing proteins that are essential to them. Without these proteins the bacteria cannot grow, replicate and increase in numbers. Azithromycin therefore stops the spread of infection and remaining bacteria are killed by the body's immune system or eventually die.

Azithromycin is a broad-spectrum antibiotic that is active against a wide variety of bacteria that cause a wide variety of infections. Clamelle tablets are used to treat the sexually-transmitted infection chlamydia. Two tablets are taken together as a single dose.

What is it used for?

  • Treatment of confirmed genital chlamydia infection without symptoms in people aged 16 years and over and their sexual partners.

Clamelle tablets can be bought without a prescription from participating pharmacies as part of the Clamelle chlamydia testing service. First, you buy and use the Clamelle chlamydia test kit, which is a simple urine test that is sent off to a laboratory. You can choose to have your result sent to you in the post, or to find out your result by returning to the pharmacy. The results are usually ready within seven days

If your test comes back positive and you don’t have any symptoms of STIs, you can then buy Clamelle tablets to treat the infection. You will need to take either your results letter, or the verification tear off slip from your test, to the pharmacy. The pharmacist will verify your result online first, using the secure lab database, and will then ask you some questions to make sure it is safe for you to take the tablets.

If you have tested positive, the pharmacist will provide you with partner notification slip(s) for you to give or send to your partner(s) to help with letting them know they may have chlamydia and encouraging them to seek treatment. Partners can then use this notification slip to buy Clamelle tablets from the pharmacy (if suitable) without needing to buy a test.

You can also buy Clamelle tablets if you have a positive NHS chlamydia test, providing you take the result slip to the pharmacy and the pharmacist decides you are eligible. If you are a partner of someone who has had a positive NHS chlamydia test, you can also buy Clamelle tablets, provided the pharmacist decides you are eligible. You will need to take your NHS partner notification slip to the pharmacy.

Warning!

  • Both Clamelle tablets should be taken together as a single dose, as soon as possible after your positive test result. They should ideally be taken before bedtime and at least two hours after any food or drink (other than water). This is to reduce the risk of vomiting.
  • If you vomit within three hours of taking Clamelle tablets they may not be effective at clearing up the infection. You should consult your GP or sexual health clinic for advice.
  • You should not have sex (oral, vaginal, anal or use of sex toys), even with a condom, for seven days after both you and you partner have been treated with Clamelle tablets. This is to avoid re-infection.
  • If you are taking an oral contraceptive pill and experience severe diarrhoea or vomiting after taking Clamelle tablets, this may make your pill less effective. You should keep taking your pill at your normal time, but refer to the patient information leaflet for your pill and follow the instructions for minimising the risk of contraceptive failure.
  • All antibiotics can sometimes result in overgrowth of organisms that are not susceptible to the antibiotic, in particular fungi. You should let your doctor know if you think you have developed any other infections after taking this medicine, so that they can be treated appropriately.
  • If you have tested positive for chlamydia you may also be at risk of having other STIs, so you should visit your local sexual health clinic for further testing and treatment. This medicine only treats chlamydia.

Not to be used in

  • People who have symptoms of chlamydia (eg an unusual discharge, pain when passing urine, pain when having sex, vaginal bleeding between periods or after sex, pain or swelling in the testicles, or in women, unexplained pain below your belly button). You will need to consult your GP or sexual health clinic if you have chlamydia symptoms.
  • People with symptoms of any other sexually transmitted infections (for example any lumps, bumps, sores or blisters around the genital or anal area). If you have any symptoms of STIs you will need to consult your GP or sexual health clinic.
  • Children under 16 years of age.
  • Decreased kidney function.
  • Decreased liver function.
  • People with any history of heart problems.
  • Pregnancy.
  • Breastfeeding.
  • Allergy to macrolide or ketolide type antibiotics, eg erythromycin.
  • People already taking azithromycin for another infection.
  • People who have taken azithromycin or another medicine to treat chlamydia in the last six months. In this case, you will need to visit your GP or sexual health clinic, as there is an increased risk of complications with each infection of chlamydia.
  • People taking certain other medicines (see ‘How can this medicine affect other medicines’ below for details).

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.

If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

  • The safety of this medicine for use during pregnancy has not been established. It should not be used during pregnancy. If you are pregnant and have tested positive for chlamydia you should seek medical advice from your doctor.
  • The safety of this medicine for use during breastfeeding has not been established. It should not be taken by women who are breastfeeding. Seek medical advice from your doctor if you are breastfeeding.

Label warnings

  • Do not take indigestion remedies at the same time as this medication.
  • To be taken on an empty stomach.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here does not mean that all people using this medicine will experience that or any side effect.

Common (affect between 1 in 10 and 1 in 100 people)

  • Disturbances of the gut such as diarrhoea, nausea, vomiting or abdominal pain. If you vomit within three hours of taking Clamelle tablets they may not be effective at clearing up the infection. You should consult your GP or sexual health clinic for advice.

Uncommon (affect between 1 in 100 and 1 in 1000 people)

  • Loss of appetite.
  • Allergic skin reactions, eg rash, itching.
  • Pain in the joints (arthralgia).
  • Inflammation of the vagina (vaginitis).
  • Dizziness or sensation of spinning (vertigo).
  • Headache.
  • Sleepiness.
  • Taste disturbances.
  • Fainting.
  • Seizures (convulsions).

Rare (affect between 1 in 1000 and 1 in 10,000 people)

  • Thrush infections (candidiasis).
  • Aggressiveness, agitation, anxiety and nervousness.
  • Pins and needles sensations (paraesthesia).
  • Feeling weak (asthenia).
  • Hyperactivity.
  • Difficulty sleeping (insomnia).
  • Decrease in the number of platelets or white blood cells in the blood.
  • Hearing distubances.
  • Awareness of your heartbeat (palpitations).
  • Abnormal heart beats (arrhythmias).
  • Low blood pressure (hypotension).
  • Liver or kidney disorders.
  • Abnormal reaction of the skin to light, usually a rash (photosensitivity).

The side effects listed above may not include all of the side effects reported by the medicine's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

How can this medicine affect other medicines?

It is important to tell your pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you take this medicine. Similarly, check with your pharmacist before taking any other medicines in combination with this one, to make sure that the combination is safe.

Your pharmacist cannot sell you this medicine if you are taking any of the following medicines, because the combination may not be safe:

  • ciclosporin
  • digoxin
  • disopyramide
  • ergotamine or related medicines, eg dihydroergotamine or methysergide (used to treat migraine)
  • rifabutin
  • terfenadine
  • theophylline
  • warfarin or other coumarin anticoagulant medicines.

The manufacturers of the following medicines recommend that azithromycin is not taken in combination with these medicines:

  • mizolastine
  • pimozide
  • reboxetine.

Antacids for indigestion and heartburn reduce the absorption of azithromycin from the gut if they are taken at the same time as azithromycin. This could make the antibiotic less effective. Clamelle tablets should therefore be taken at least one hour before or two hours after taking any antacid.

If you are taking an oral contraceptive pill and experience severe diarrhoea or vomiting after taking Clamelle tablets, this may make your pill less effective. You should keep taking your pill at your normal time, but refer to the patient information leaflet for your pill and follow the instructions for minimising the risk of contraceptive failure.

Other medicines containing the same active ingredient

Zithromax

Azithromycin is also available without a brand name, ie as the generic medicine.