Drug interactions
Buprenorphine transdermal + Clarithromycin
Severity: Major
Buprenorphine transdermal 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 inhibits CYP3A4 and can increase buprenorphine exposure, raising the risk of sedation and respiratory depression. Both drugs can also prolong the QT interval.
What this interaction means in plain words
Buprenorphine transdermal 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.
Why it happens
CYP3A4 inhibition raising buprenorphine levels with additive QT prolongation.
What to do
Prefer a non-CYP3A4-inhibiting antibiotic. If combined, monitor for respiratory depression and sedation and obtain an ECG in at-risk patients.
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
Frequently asked questions
Can I take Buprenorphine transdermal with Clarithromycin?
MediHelp rates the interaction as major. Buprenorphine transdermal 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 inhibits CYP3A4 and can increase buprenorphine exposure, raising the risk of sedation and respiratory depression. Both drugs can also prolong the QT interval.
How serious is the interaction between Buprenorphine transdermal 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: Prefer a non-CYP3A4-inhibiting antibiotic. If combined, monitor for respiratory depression and sedation and obtain an ECG in at-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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