Drug interactions
Clarithromycin + Erythromycin lactobionate
Severity: Major
Clarithromycin and Erythromycin lactobionate: 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
Two macrolides taken together add QT-prolonging effects and offer no therapeutic benefit. Intravenous erythromycin gives high concentrations, and both agents inhibit CYP3A4, increasing the risk of arrhythmia and adverse effects.
What this interaction means in plain words
Clarithromycin and Erythromycin lactobionate 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; Erythromycin lactobionate belongs to Anti Bacterial.
Why it happens
Additive QT prolongation and mutual CYP3A4 inhibition.
What to do
Avoid concurrent use of two macrolides and choose a single agent appropriate to the infection.
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 Erythromycin lactobionate
- Cisapride + Erythromycin lactobionate Contraindicated
- Dihydroergotamine + Erythromycin lactobionate Contraindicated
- Dronedarone + Erythromycin lactobionate Contraindicated
- Eletriptan + Erythromycin lactobionate Contraindicated
- Ergotamine + Erythromycin lactobionate Contraindicated
- Erythromycin lactobionate + Flibanserin Contraindicated
Frequently asked questions
Can I take Clarithromycin with Erythromycin lactobionate?
MediHelp rates the interaction as major. Clarithromycin and Erythromycin lactobionate 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. Two macrolides taken together add QT-prolonging effects and offer no therapeutic benefit. Intravenous erythromycin gives high concentrations, and both agents inhibit CYP3A4, increasing the risk of arrhythmia and adverse effects.
How serious is the interaction between Clarithromycin and Erythromycin lactobionate?
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 concurrent use of two macrolides and choose a single agent appropriate to the infection.
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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