Drug interactions
Apalutamide + Clarithromycin
Severity: Moderate
Apalutamide and Clarithromycin: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Apalutamide is a strong CYP3A4 inducer and can lower clarithromycin concentrations, though it may increase the active 14-hydroxy metabolite. Antibacterial efficacy may be reduced.
What this interaction means in plain words
Apalutamide and Clarithromycin can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Apalutamide belongs to Endocrine; Clarithromycin belongs to Anti Bacterial.
Why it happens
Induction of CYP3A4 by apalutamide increases clarithromycin clearance.
What to do
Consider an alternative antibiotic not dependent on CYP3A4, such as azithromycin when appropriate. If clarithromycin is used, assess clinical response closely.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Clarithromycin
- Astemizole + Clarithromycin Contraindicated
- Avanafil + Clarithromycin Contraindicated
- Cisapride + Clarithromycin Contraindicated
- Clarithromycin + Colchicine Contraindicated
- Clarithromycin + Conivaptan Contraindicated
- Clarithromycin + Dihydroergotamine Contraindicated
Other interactions of Apalutamide
- Apalutamide + Cabotegravir Contraindicated
- Apalutamide + Cobicistat Contraindicated
- Apalutamide + Doravirine Contraindicated
- Apalutamide + Elbasvir / grazoprevir Contraindicated
- Apalutamide + Ensitrelvir Contraindicated
- Apalutamide + Fostemsavir Contraindicated
Frequently asked questions
Can I take Apalutamide with Clarithromycin?
MediHelp rates the interaction as moderate. Apalutamide and Clarithromycin can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Apalutamide is a strong CYP3A4 inducer and can lower clarithromycin concentrations, though it may increase the active 14-hydroxy metabolite. Antibacterial efficacy may be reduced.
How serious is the interaction between Apalutamide and Clarithromycin?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Consider an alternative antibiotic not dependent on CYP3A4, such as azithromycin when appropriate. If clarithromycin is used, assess clinical response closely.
What other medicines interact with Clarithromycin?
MediHelp also lists interactions of Clarithromycin with, for example, Astemizole, Avanafil, Cisapride. The full list is on the Clarithromycin page.
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