Monitor QTc in patients with increased risk

Prolongation of QTc interval. Association with increased cardiovascular mortality in observational studies.

Prolonged half life may contribute to macrolide resistance.

• Other drugs that prolong QTc
• Increases cyclosporine levels
• May increase digoxin levels
• Statins increased risk of rhabdomyolysis

Bioavailability: 37% - low

• The low bioavailability is compensated with very high tissue penetration.
• Very high tissue penetration and concentration intracellularly means in vivo activity may not be predicted by in vitro testing - e.g. Salmonella species.