Drug interactions
Clarithromycin + Dabigatran etexilate
Severity: Major
Clarithromycin and Dabigatran etexilate: 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 is a P-glycoprotein inhibitor that increases dabigatran exposure and bleeding risk. The effect is more concerning in older patients and in those with reduced renal function.
What this interaction means in plain words
Clarithromycin and Dabigatran etexilate 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; Dabigatran etexilate belongs to Cardiovascular.
Why it happens
Inhibition of P-glycoprotein efflux of dabigatran etexilate, increasing its absorption.
What to do
Avoid in patients with renal impairment; otherwise monitor closely for bleeding and consider an alternative antibiotic such as doxycycline if appropriate. Follow labeling dose recommendations for P-gp inhibitors.
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 Dabigatran etexilate
- Dabigatran etexilate + Defibrotide Contraindicated
- Dabigatran etexilate + Ketorolac Contraindicated
- Dabigatran etexilate + Mifepristone Contraindicated
- Abciximab + Dabigatran etexilate Major
- Alteplase + Dabigatran etexilate Major
- Amiodarone + Dabigatran etexilate Major
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 Clarithromycin with Dabigatran etexilate?
MediHelp rates the interaction as major. Clarithromycin and Dabigatran etexilate 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 is a P-glycoprotein inhibitor that increases dabigatran exposure and bleeding risk. The effect is more concerning in older patients and in those with reduced renal function.
How serious is the interaction between Clarithromycin and Dabigatran etexilate?
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 in patients with renal impairment; otherwise monitor closely for bleeding and consider an alternative antibiotic such as doxycycline if appropriate. Follow labeling dose recommendations for P-gp inhibitors.
What other medicines interact with Dabigatran etexilate?
MediHelp also lists interactions of Dabigatran etexilate with, for example, Defibrotide, Ketorolac, Mifepristone. The full list is on the Dabigatran etexilate page.
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