Drug interactions
Clarithromycin + Disopyramide
Severity: Major
Clarithromycin and Disopyramide: 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
Both drugs prolong the QT interval, and clarithromycin can also raise disopyramide levels. Together they increase the risk of torsades de pointes and ventricular arrhythmia. Hypoglycemia and anticholinergic toxicity from higher disopyramide exposure have also been reported.
What this interaction means in plain words
Clarithromycin and Disopyramide 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; Disopyramide belongs to Cardiovascular.
Why it happens
Additive QT prolongation, plus CYP3A4 inhibition by clarithromycin that decreases disopyramide metabolism.
What to do
Avoid the combination where possible and choose a non-QT-prolonging antibiotic. If unavoidable, obtain a baseline ECG, correct potassium and magnesium, and monitor QTc and disopyramide 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 Disopyramide
- Amisulpride + Disopyramide Contraindicated
- Desipramine + Disopyramide Contraindicated
- Disopyramide + Dronedarone Contraindicated
- Disopyramide + Itraconazole Contraindicated
- Disopyramide + Ketoconazole Contraindicated
- Disopyramide + Maprotiline Contraindicated
Frequently asked questions
Can I take Clarithromycin with Disopyramide?
MediHelp rates the interaction as major. Clarithromycin and Disopyramide 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. Both drugs prolong the QT interval, and clarithromycin can also raise disopyramide levels. Together they increase the risk of torsades de pointes and ventricular arrhythmia. Hypoglycemia and anticholinergic toxicity from higher disopyramide exposure have also been reported.
How serious is the interaction between Clarithromycin and Disopyramide?
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 the combination where possible and choose a non-QT-prolonging antibiotic. If unavoidable, obtain a baseline ECG, correct potassium and magnesium, and monitor QTc and disopyramide 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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