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Drug interactions

Clarithromycin + Eliglustat

Severity: Contraindicated

Clarithromycin and Eliglustat: contraindicated 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 strongly inhibits CYP3A4 and can substantially raise eliglustat exposure, which is associated with PR, QRS and QT interval prolongation and arrhythmia. The risk is highest in CYP2D6 poor or intermediate metabolizers and when CYP2D6 is also inhibited.

What this interaction means in plain words

Clarithromycin and Eliglustat are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.

Clarithromycin belongs to Anti Bacterial; Eliglustat belongs to Miscellaneous.

Evidence level: High

Why it happens

Clarithromycin inhibits CYP3A4, a key metabolic pathway for eliglustat, increasing its plasma concentration.

What to do

Avoid in CYP2D6 intermediate or poor metabolizers and in patients on CYP2D6 inhibitors; otherwise use a different antibiotic or reduce eliglustat dose per labeling with ECG monitoring.

What to ask your pharmacist

  • Is there an alternative to one of these two medicines for me?
  • If both are essential, who is monitoring me and how often?
  • Which symptoms mean I should stop and seek help straight away?

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 Eliglustat?

MediHelp rates the interaction as contraindicated. Clarithromycin and Eliglustat are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Clarithromycin strongly inhibits CYP3A4 and can substantially raise eliglustat exposure, which is associated with PR, QRS and QT interval prolongation and arrhythmia. The risk is highest in CYP2D6 poor or intermediate metabolizers and when CYP2D6 is also inhibited.

How serious is the interaction between Clarithromycin and Eliglustat?

MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid in CYP2D6 intermediate or poor metabolizers and in patients on CYP2D6 inhibitors; otherwise use a different antibiotic or reduce eliglustat dose per labeling with ECG monitoring.

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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