Drug interactions
Aprepitant + Clarithromycin
Severity: Moderate
Aprepitant 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 is a strong CYP3A4 inhibitor and increases aprepitant exposure. This can increase aprepitant adverse effects, and aprepitant may in turn raise clarithromycin-related exposure of other CYP3A4 substrates.
What this interaction means in plain words
Aprepitant 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.
Aprepitant belongs to Gastrointestinal Tract; Clarithromycin belongs to Anti Bacterial.
Why it happens
Strong CYP3A4 inhibition by clarithromycin decreases aprepitant clearance.
What to do
Use with monitoring for aprepitant toxicity, or consider an antibiotic with less CYP3A4 inhibition such as azithromycin. No fixed dose adjustment is established.
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 Aprepitant
- Aprepitant + Lomitapide Contraindicated
- Aprepitant + Pimozide Contraindicated
- Aprepitant + Avapritinib Major
- Aprepitant + Bosutinib Major
- Aprepitant + Carbamazepine Major
- Aprepitant + Cobicistat Major
Other interactions of Clarithromycin
- Astemizole + Clarithromycin Contraindicated
- Avanafil + Clarithromycin Contraindicated
- Cisapride + Clarithromycin Contraindicated
- Clarithromycin + Colchicine Contraindicated
- Clarithromycin + Conivaptan Contraindicated
- Clarithromycin + Dihydroergotamine Contraindicated
Frequently asked questions
Can I take Aprepitant with Clarithromycin?
MediHelp rates the interaction as moderate. Aprepitant 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 is a strong CYP3A4 inhibitor and increases aprepitant exposure. This can increase aprepitant adverse effects, and aprepitant may in turn raise clarithromycin-related exposure of other CYP3A4 substrates.
How serious is the interaction between Aprepitant 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: Use with monitoring for aprepitant toxicity, or consider an antibiotic with less CYP3A4 inhibition such as azithromycin. No fixed dose adjustment is established.
What other medicines interact with Aprepitant?
MediHelp also lists interactions of Aprepitant with, for example, Lomitapide, Pimozide, Avapritinib. The full list is on the Aprepitant page.
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