Drug interactions
Clarithromycin + Elbasvir / grazoprevir
Severity: Major
Clarithromycin and Elbasvir / grazoprevir: 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 may increase concentrations of both elbasvir and grazoprevir. Higher grazoprevir exposure is associated with an increased risk of ALT elevation and hepatotoxicity.
What this interaction means in plain words
Clarithromycin and Elbasvir / grazoprevir 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.
Why it happens
Clarithromycin inhibits CYP3A4 and P-glycoprotein, which clear elbasvir and grazoprevir, and may also inhibit OATP1B.
What to do
Use an alternative antibiotic such as azithromycin during HCV therapy. If it cannot be avoided, monitor liver enzymes closely.
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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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 Elbasvir / grazoprevir?
MediHelp rates the interaction as major. Clarithromycin and Elbasvir / grazoprevir 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 may increase concentrations of both elbasvir and grazoprevir. Higher grazoprevir exposure is associated with an increased risk of ALT elevation and hepatotoxicity.
How serious is the interaction between Clarithromycin and Elbasvir / grazoprevir?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use an alternative antibiotic such as azithromycin during HCV therapy. If it cannot be avoided, monitor liver enzymes closely.
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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