Drug interactions
Bosutinib + Clarithromycin
Severity: Major
Bosutinib and Clarithromycin: major 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 markedly raises bosutinib concentrations by inhibiting its CYP3A4 metabolism and P-glycoprotein efflux. This can cause hepatotoxicity, diarrhea, myelosuppression and QT effects.
What this interaction means in plain words
Bosutinib and Clarithromycin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Bosutinib belongs to Oncology; Clarithromycin belongs to Anti Bacterial.
Why it happens
Inhibition of CYP3A4 and P-glycoprotein reduces bosutinib clearance.
What to do
Avoid the combination and use an alternative antibiotic like azithromycin. If unavoidable, monitor closely for toxicity and consider bosutinib dose reduction per labeling.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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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 Bosutinib
- Amiodarone + Bosutinib Major
- Apalutamide + Bosutinib Major
- Aprepitant + Bosutinib Major
- Bosentan + Bosutinib Major
- Bosutinib + Carbamazepine Major
- Bosutinib + Chlorpromazine Major
Frequently asked questions
Can I take Bosutinib with Clarithromycin?
MediHelp rates the interaction as major. Bosutinib and Clarithromycin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Clarithromycin markedly raises bosutinib concentrations by inhibiting its CYP3A4 metabolism and P-glycoprotein efflux. This can cause hepatotoxicity, diarrhea, myelosuppression and QT effects.
How serious is the interaction between Bosutinib and Clarithromycin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination and use an alternative antibiotic like azithromycin. If unavoidable, monitor closely for toxicity and consider bosutinib dose reduction per labeling.
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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