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Drug interactions

Clarithromycin + Duvelisib

Severity: Major

Clarithromycin and Duvelisib: major 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 significantly raises duvelisib exposure, increasing the risk of serious infections, diarrhea or colitis, cutaneous reactions and pneumonitis. Duvelisib may also inhibit CYP3A4 and raise clarithromycin levels.

What this interaction means in plain words

Clarithromycin and Duvelisib 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; Duvelisib belongs to Oncology.

Evidence level: High

Why it happens

Clarithromycin is a strong CYP3A4 inhibitor that reduces duvelisib metabolism; duvelisib is itself a CYP3A4 inhibitor.

What to do

Reduce duvelisib to 15 mg twice daily during the combination, as labeled. Monitor for toxicity, or use a non-CYP3A4-inhibiting antibiotic.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Clarithromycin with Duvelisib?

MediHelp rates the interaction as major. Clarithromycin and Duvelisib 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 significantly raises duvelisib exposure, increasing the risk of serious infections, diarrhea or colitis, cutaneous reactions and pneumonitis. Duvelisib may also inhibit CYP3A4 and raise clarithromycin levels.

How serious is the interaction between Clarithromycin and Duvelisib?

MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reduce duvelisib to 15 mg twice daily during the combination, as labeled. Monitor for toxicity, or use a non-CYP3A4-inhibiting antibiotic.

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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