Drug interactions
Apixaban + Clarithromycin
Severity: Moderate
Apixaban 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
Clarithromycin raises apixaban exposure modestly, and this may slightly increase bleeding risk. The increase is considered small enough that labeling does not require dose adjustment, though the risk may be higher in renal impairment or with other bleeding risk factors.
What this interaction means in plain words
Apixaban 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.
Apixaban belongs to Cardiovascular; Clarithromycin belongs to Anti Bacterial.
Why it happens
Clarithromycin inhibits CYP3A4 and P-glycoprotein, which both contribute to apixaban clearance.
What to do
No routine dose change is needed, but monitor for bleeding, especially in patients with renal impairment or other interacting drugs, and consider an alternative antibiotic in high-risk patients.
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 Apixaban
- Apixaban + Dabigatran Contraindicated
- Apixaban + Defibrotide Contraindicated
- Apixaban + Edoxaban Contraindicated
- Apixaban + Ketorolac Contraindicated
- Apixaban + Mifepristone Contraindicated
- Abciximab + Apixaban Major
Frequently asked questions
Can I take Apixaban with Clarithromycin?
MediHelp rates the interaction as moderate. Apixaban 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. Clarithromycin raises apixaban exposure modestly, and this may slightly increase bleeding risk. The increase is considered small enough that labeling does not require dose adjustment, though the risk may be higher in renal impairment or with other bleeding risk factors.
How serious is the interaction between Apixaban 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: No routine dose change is needed, but monitor for bleeding, especially in patients with renal impairment or other interacting drugs, and consider an alternative antibiotic in high-risk patients.
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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