Drug interactions
Clarithromycin + Clopidogrel
Severity: Moderate
Clarithromycin and Clopidogrel: 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 may reduce activation of clopidogrel to its active metabolite, potentially weakening platelet inhibition. Observational data suggest a possible increase in adverse cardiovascular events, though evidence is inconsistent.
What this interaction means in plain words
Clarithromycin and Clopidogrel 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 belongs to Anti Bacterial; Clopidogrel belongs to Cardiovascular.
Why it happens
CYP3A4 inhibition reduces the oxidative bioactivation of clopidogrel.
What to do
Prefer azithromycin or another antibiotic without CYP3A4 inhibition in patients needing full antiplatelet effect, such as after stenting. Monitor for thrombotic events if combined.
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 Clopidogrel
Frequently asked questions
Can I take Clarithromycin with Clopidogrel?
MediHelp rates the interaction as moderate. Clarithromycin and Clopidogrel 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 may reduce activation of clopidogrel to its active metabolite, potentially weakening platelet inhibition. Observational data suggest a possible increase in adverse cardiovascular events, though evidence is inconsistent.
How serious is the interaction between Clarithromycin and Clopidogrel?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Prefer azithromycin or another antibiotic without CYP3A4 inhibition in patients needing full antiplatelet effect, such as after stenting. Monitor for thrombotic events if combined.
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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