Drug interactions
Clarithromycin + Cobicistat
Severity: Major
Clarithromycin and Cobicistat: major interaction.
Last updated Sources: US FDA label
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 and cobicistat are both CYP3A4 inhibitors and substrates, so each can raise the other's concentrations. This may increase clarithromycin toxicity such as QT prolongation and effects of cobicistat-boosted drugs.
What this interaction means in plain words
Clarithromycin and Cobicistat 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 belongs to Anti Bacterial; Cobicistat belongs to Miscellaneous.
Why it happens
Mutual CYP3A4 inhibition reduces metabolism of both drugs.
What to do
Consider an alternative antibiotic such as azithromycin. If clarithromycin is used, adjust the dose for renal function as labeled and monitor ECG and adverse effects.
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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References
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 Cobicistat
- Alfuzosin + Cobicistat Contraindicated
- Apalutamide + Cobicistat Contraindicated
- Cobicistat + Colchicine Contraindicated
- Cobicistat + Dronedarone Contraindicated
- Cobicistat + Eletriptan Contraindicated
- Cobicistat + Eplerenone Contraindicated
Frequently asked questions
Can I take Clarithromycin with Cobicistat?
MediHelp rates the interaction as major. Clarithromycin and Cobicistat 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 and cobicistat are both CYP3A4 inhibitors and substrates, so each can raise the other's concentrations. This may increase clarithromycin toxicity such as QT prolongation and effects of cobicistat-boosted drugs.
How serious is the interaction between Clarithromycin and Cobicistat?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Consider an alternative antibiotic such as azithromycin. If clarithromycin is used, adjust the dose for renal function as labeled and monitor ECG and adverse 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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