CLARITHROMYCIN Drug Interactions
Also known as: Clarithromycin
CLARITHROMYCIN (brand name: Clarithromycin) is a Macrolide Antibiotics. 1.1 Acute Bacterial Exacerbation of Chronic Bronchitis Clarithromycin tablets are indicated in adults for the treatment of mild to moderate infections caused by susceptible isolates due to Haemophilus influenzae, Haemophilus parainfluenzae, Moraxella catarrhalis, or Streptococcus pneumoniae [see…CLARITHROMYCIN has 2 documented drug interactions in our database, including 0 contraindicated, 1 major, 1 moderate, and 0 minor interactions.
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Contraindicated
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Major
1
Moderate
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Minor
Clarithromycin significantly increases atorvastatin exposure, raising the risk of myopathy and rhabdomyolysis.
Mechanism
Clarithromycin is a potent CYP3A4 inhibitor, reducing atorvastatin first-pass metabolism and increasing plasma levels up to 4-fold.
Clinical Management
Temporarily suspend atorvastatin during short courses of clarithromycin, or use a non-CYP3A4 statin (pravastatin, rosuvastatin).
Co-administration of azithromycin and clarithromycin is generally not recommended as both are macrolide antibiotics with similar mechanisms of action and adverse effect profiles. Their combined use offers no additional therapeutic benefit and increases the risk of cumulative side effects, particularly QT interval prolongation and gastrointestinal disturbances.
Mechanism
Both azithromycin and clarithromycin exert their antibacterial effects by inhibiting bacterial protein synthesis via binding to the 50S ribosomal subunit. They also share the potential to prolong the cardiac QT interval, although clarithromycin's effect is generally more pronounced.
Clinical Management
Avoid concurrent use of azithromycin and clarithromycin due to therapeutic redundancy and an increased risk of additive adverse effects. If a macrolide antibiotic is indicated, select one agent based on susceptibility and patient factors. If a broader spectrum or different class of antibiotic is needed, choose an agent from a different class to avoid synergistic toxicity.
For complete prescribing information:
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