Drug interactions
Cabozantinib + Clarithromycin
Severity: Major
Cabozantinib 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 raises cabozantinib exposure through CYP3A4 inhibition, which may increase toxicities such as diarrhea, hypertension, hand-foot syndrome and hemorrhage.
What this interaction means in plain words
Cabozantinib 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.
Cabozantinib belongs to Oncology; Clarithromycin belongs to Anti Bacterial.
Why it happens
Inhibition of CYP3A4-mediated metabolism of cabozantinib.
What to do
Avoid if possible and use a non-CYP3A4-inhibiting antibiotic. If required, reduce the cabozantinib dose per labeling and resume the prior dose 2 to 3 days after stopping clarithromycin.
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 Cabozantinib
Frequently asked questions
Can I take Cabozantinib with Clarithromycin?
MediHelp rates the interaction as major. Cabozantinib 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 raises cabozantinib exposure through CYP3A4 inhibition, which may increase toxicities such as diarrhea, hypertension, hand-foot syndrome and hemorrhage.
How serious is the interaction between Cabozantinib 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 if possible and use a non-CYP3A4-inhibiting antibiotic. If required, reduce the cabozantinib dose per labeling and resume the prior dose 2 to 3 days after stopping clarithromycin.
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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