Drug interactions
Clarithromycin + Elvitegravir / cobicistat / emtricitabine / tenofovir df
Severity: Moderate
Clarithromycin and Elvitegravir / cobicistat / emtricitabine / tenofovir df: moderate 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
Cobicistat is a strong CYP3A4 inhibitor, so clarithromycin and cobicistat can increase each other's concentrations. Clarithromycin levels rise, especially in renal impairment, and elvitegravir/cobicistat exposure may also increase, raising the risk of QT prolongation and other adverse effects.
What this interaction means in plain words
Clarithromycin and Elvitegravir / cobicistat / emtricitabine / tenofovir df can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Mutual inhibition of CYP3A4 and P-glycoprotein by clarithromycin and cobicistat reduces clearance of both.
What to do
Reduce the clarithromycin dose in patients with reduced creatinine clearance, and monitor for QT prolongation and adverse effects. Azithromycin is an alternative that avoids the interaction.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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 Elvitegravir / cobicistat / emtricitabine / tenofovir df?
MediHelp rates the interaction as moderate. Clarithromycin and Elvitegravir / cobicistat / emtricitabine / tenofovir df can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Cobicistat is a strong CYP3A4 inhibitor, so clarithromycin and cobicistat can increase each other's concentrations. Clarithromycin levels rise, especially in renal impairment, and elvitegravir/cobicistat exposure may also increase, raising the risk of QT prolongation and other adverse effects.
How serious is the interaction between Clarithromycin and Elvitegravir / cobicistat / emtricitabine / tenofovir df?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reduce the clarithromycin dose in patients with reduced creatinine clearance, and monitor for QT prolongation and adverse effects. Azithromycin is an alternative that avoids the interaction.
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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