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If you need urgent assistance, do not use this service. Call 111, or in an emergency call 999.
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A macrolide antibiotic for bacterial sinus infections, mainly used if you are allergic to penicillin. Prescribed after an online consultation with a UK prescriber, with no GP appointment needed.
Not sure if you need an antibiotic? Most sinus infections are viral and clear on their own. A UK prescriber will check whether clarithromycin is right for you, including the other medicines you take, before anything is dispensed. You only pay if it is prescribed. If you have swelling around the eye, changes in your vision or a severe headache, get urgent medical help by calling 111, or 999 in an emergency.
Order before 3pm — same-day dispatch (MON - FRI)
~5 min consultation
Secure & confidential · Reviewed by a UK prescriber
Suitable age
18 years +
Max per order
1 course
Consultation
Yes, online (included in the price)
Clarithromycin is a macrolide antibiotic. It is licensed in the UK to treat upper respiratory tract infections, including sinusitis caused by bacteria. It works by stopping bacteria from making the proteins they need to grow, so your immune system can clear the infection and the facial pain, pressure and congestion can settle.
Most sinusitis is caused by a virus and gets better within two to three weeks, and antibiotics do not help with viral infections. NICE recommends an antibiotic only when a bacterial infection is likely: if you are very unwell or at high risk of complications, or as a back-up if symptoms have lasted 10 days or more and are getting worse. Where an antibiotic is needed, phenoxymethylpenicillin is the usual first choice. Clarithromycin and doxycycline are the first choices if you are allergic to penicillin or can’t take it. Our guide to clarithromycin and doxycycline for sinusitis compares the two.
Clarithromycin interacts with a number of common medicines, so the prescriber checks everything you take. If it is right for you, a GPhC-registered pharmacist independent prescriber issues the prescription and it is dispensed by our UK pharmacy in plain packaging. If it is not, the prescriber will explain why and tell you where to get the right care.
| Active ingredient | Clarithromycin 500 mg tablets |
| Type | Macrolide antibiotic (oral tablets) |
| Used for | Sinusitis caused by bacteria (licensed use); first choice if allergic to penicillin |
| Typical dose | 500mg (1 tablet) twice a day, about 12 hours apart |
| Pack size | 5 days, 10 tablets |
| Prescription | POM — reviewed by a UK prescriber |
| How supplied | After an online consultation with a UK prescriber |
Most sinus infections are caused by viruses and get better on their own within two to three weeks. For the first 10 days, rest, fluids, pain relief and saline rinses are usually all you need. If symptoms have lasted 10 days or more without improving, a steroid nasal spray is often the more useful next step. Our guide to steroid spray vs antibiotics explains why.
An antibiotic may be needed if:
you are very unwell, with a high temperature or severe facial pain;
you got better and then clearly worse again (“double sickening”);
you are at high risk of complications, for example because of a weakened immune system.
Our guides on whether a sinus infection is bacterial or viral and whether you need antibiotics go into the detail.
Clarithromycin in particular is a first choice if you are allergic to penicillin or can’t take it. If you can take penicillin, phenoxymethylpenicillin is usually preferred, although it is currently affected by a UK-wide supply shortage, so your prescriber will advise on the best option.
Clarithromycin is not suitable if you:
are allergic to clarithromycin or another macrolide antibiotic, such as erythromycin or azithromycin;
have had a heart rhythm problem called QT prolongation, or an irregular heartbeat from the lower chambers of the heart;
have low potassium or magnesium levels;
have severe liver failure together with kidney problems;
ake certain medicines, including simvastatin, lovastatin, colchicine, ticagrelor, ranolazine, ivabradine, domperidone, ergotamine, pimozide or midazolam taken by mouth. Your prescriber checks your full medicine list.
It isn’t usually prescribed in pregnancy. Tell the prescriber if you are pregnant, might be, or are breastfeeding.
Get urgent help (call 111, or 999 in an emergency) if you have swelling or redness around the eye, double or reduced vision, a severe headache, a stiff neck or confusion.
Clarithromycin is licensed in the UK for sinusitis and works against the bacteria that commonly cause it. NICE lists it as a first choice for people who are allergic to penicillin. Most sinusitis is viral, though, and antibiotics don’t help viral infections, so a prescriber first checks whether a bacterial infection is likely.
Many people start to feel better within 2 to 3 days. Finish the full 5-day course even if you feel better sooner. If you are no better after the course, or get worse at any point, speak to a GP.
The usual adult dose is 500mg twice a day, about 12 hours apart, for 5 days. That is 10 tablets in total. Always follow the dose on your label.
NICE lists both as first choices for people allergic to penicillin, and neither is clearly better. Clarithromycin is taken twice a day and interacts with more medicines, such as simvastatin and colchicine. Doxycycline is taken once a day and makes your skin burn more easily in the sun. Our guide to clarithromycin and doxycycline for sinusitis compares them.
If you can’t take clarithromycin, doxycycline is the other first-choice antibiotic for people allergic to penicillin. If you can take penicillin, phenoxymethylpenicillin is usually preferred. For symptoms that have lasted 10 days or more without being very unwell, a steroid nasal spray is often more useful than any antibiotic.
Not with simvastatin or lovastatin: clarithromycin must not be taken with them, because it can raise statin levels and cause serious muscle damage. With other statins, your prescriber may ask you to pause the statin during the course or monitor you. Always list every medicine you take during the consultation.
It isn’t usually prescribed in pregnancy, and NICE lists it for sinusitis only for people who are not pregnant. Small amounts pass into breast milk. Tell the prescriber if you are pregnant, might be, or are breastfeeding, so they can advise on a suitable option.
The most common are diarrhoea, feeling sick, indigestion, stomach pain, a bitter or metallic taste, headache and difficulty sleeping. Get help straight away for a serious allergic reaction, a fast or irregular heartbeat, yellowing of the skin or eyes, or severe diarrhoea.
Don’t take it if you are allergic to clarithromycin or other macrolides, have had QT prolongation or certain heart rhythm problems, have low potassium or magnesium, or take medicines such as simvastatin, colchicine, ticagrelor or domperidone. Our service is for adults aged 18 and over.
Alcohol doesn’t stop clarithromycin working, so a small amount is usually fine. Both can upset your stomach, though, and you are likely to recover faster if you rest, drink plenty of water and keep alcohol low until you feel better.
No. Clarithromycin is a prescription-only medicine. You can get it online after a consultation with a GPhC-registered pharmacist independent prescriber, who checks that a bacterial infection is likely and that it is safe for you. It is then dispensed by our UK pharmacy.
Helpful articles and clinical guides related to this treatment category.
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