Interactions

Drug-Drug

• Clarithromycin is an inhibitor of the CYP3A enzyme system. Concurrent use with other agents metabolized by this system can ↑ levels and risk of toxicity

• May prolong the QT interval and ↑ risk of arrhythmias with pimozide ; concurrent use is contraindicated

• Similar effects may occur with antiarrhythmics; ECG should be monitored for QTc prolongation and serum levels monitored

• May ↑ serum levels and the risk of toxicity from carbamazepine , some benzodiazepines (midazolam, triazolam, alprazolam) , cyclosporine , buspirone , disopyramide , ergot alkaloids , felodipine , omeprazole , tacrolimus , digoxin , or theophylline

• Ritonavir ↑ blood levels (↓ clarithromycin dose in patients with CC <60 mL/min)

• ↑ levels of HMG-CoA reductase inhibitors and may ↑ risk of rhabdomyolysis

• May ↑ effect of warfarin and sildenafil (dose reduction may be warranted)

• May ↑ or ↓ effects of zidovudine

• Blood levels are ↑ by delavirdine and fluconazole

• Blood levels may be ↓ by rifampin and rifabutin . ↑ risk of colchicine toxicty when administered with colchicine , especially in the elderly

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