Pharyngitis, tonsilitis, sinusitis and otitis media, pneumonia and acute bronchitis. 

Abdominal discomfort and cramps, nausea, vomiting, and diarrhea Hypersentivity reactions are uncommon and may include pruritis,urticaria, skin rash, angio-edema, purpura, bronchospasm, as well as occassional cases of anaphylaxis.

Allergy to macroliode antibiotics, hypersentivity

Special preacutions-

In patients with severe impaired liver function, the recommended daily dose of 150mg BID should be halved to 150mg daily.

Observe the possiblity of cross-resistence between clarithromycin and other macrolide antibiotics as well as lincomycin and clindomycin

Pharyngitis, tonsilitis, sinusitis and otitis media, pneumonia and acute bronchitis.

Pharmacology-

Roxithromycin inhibits protein synthesis by binding to the 23S rRNA molecule ( in the 50S subunit) of the bacterial ribosome blocking the exit of the growing peptide chain of sensitive microorganisms ( Human do not have 50S ribosomal subunits but have ribosome composed to 40 S and 60 S subunits). Serratiopeptidase enzyme causes lysis of proteins in the mucus secretion ttherby reduces viscocity of mucus.

Pharmacokinetics-

Roxithromycin is well absorbed following oral administration with a bioavailability of 50%. Absorption is reduced when taken after meal. Peak plasma concentrations of about 6 to 8 mcg/mL occur aroound 2 hours after a single dose of 150mg. The half-life of roxithromycin is prolonged in elderly (27 hours) in patients with impairment of hepatic function (25 hours) and in patients with impairment of renal function ( 18 hours). Seratiopeptidase is absorbed in the intestine. Combination has synergistic effect- Serratiopeptidase increases the efficacy of roxithromycin in respiratory infections by decreasing the viscosity of mucus and by reducing the neutrophil count. So the combination of roxithromycin with serratiopeptidase is more beneficial than roxithromycin in the treatment of respiratory infections.

Absorption is reduced when taken after meal.