Drug interactions
Clarithromycin + Fluticasone intranasal
Severity: Moderate
Clarithromycin and Fluticasone intranasal: 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
Strong CYP3A4 inhibition by clarithromycin can increase systemic fluticasone exposure despite the low bioavailability of the intranasal route. This can lead to systemic corticosteroid effects such as Cushing's syndrome and adrenal suppression, mainly with prolonged use.
What this interaction means in plain words
Clarithromycin and Fluticasone intranasal 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
Clarithromycin inhibits CYP3A4 metabolism of fluticasone, increasing systemic concentrations.
What to do
For short antibiotic courses the risk is modest; monitor for signs of corticosteroid excess. For longer co-therapy, consider an alternative intranasal steroid such as beclomethasone or an alternative antibiotic.
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 Fluticasone intranasal?
MediHelp rates the interaction as moderate. Clarithromycin and Fluticasone intranasal 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. Strong CYP3A4 inhibition by clarithromycin can increase systemic fluticasone exposure despite the low bioavailability of the intranasal route. This can lead to systemic corticosteroid effects such as Cushing's syndrome and adrenal suppression, mainly with prolonged use.
How serious is the interaction between Clarithromycin and Fluticasone intranasal?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: For short antibiotic courses the risk is modest; monitor for signs of corticosteroid excess. For longer co-therapy, consider an alternative intranasal steroid such as beclomethasone or an alternative 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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