Drug interactions
Cilostazol + Clarithromycin
Severity: Moderate
Cilostazol 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 increases cilostazol concentrations, which can intensify headache, tachycardia, palpitations and diarrhea. Cilostazol is also contraindicated in heart failure, so excess exposure is a concern.
What this interaction means in plain words
Cilostazol 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.
Cilostazol belongs to Cardiovascular; Clarithromycin belongs to Anti Bacterial.
Why it happens
Inhibition of CYP3A4 by clarithromycin reduces cilostazol clearance.
What to do
Reduce the cilostazol dose to 50 mg twice daily when given with a strong CYP3A4 inhibitor, or choose an alternative antibiotic. Monitor for adverse cardiovascular effects.
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 Cilostazol
Frequently asked questions
Can I take Cilostazol with Clarithromycin?
MediHelp rates the interaction as moderate. Cilostazol 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 increases cilostazol concentrations, which can intensify headache, tachycardia, palpitations and diarrhea. Cilostazol is also contraindicated in heart failure, so excess exposure is a concern.
How serious is the interaction between Cilostazol 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: Reduce the cilostazol dose to 50 mg twice daily when given with a strong CYP3A4 inhibitor, or choose an alternative antibiotic. Monitor for adverse cardiovascular effects.
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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