Drug interactions
Clarithromycin + Fluticasone-vilanterol
Severity: Major
Clarithromycin and Fluticasone-vilanterol: major interaction.
Last updated Sources: Health Canada product monograph
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 prolongs the QT interval and strongly inhibits CYP3A4, which can raise vilanterol and fluticasone furoate exposure. This increases the risk of cardiovascular beta-agonist effects and systemic corticosteroid effects.
What this interaction means in plain words
Clarithromycin and Fluticasone-vilanterol 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; Fluticasone-vilanterol belongs to Respiratory.
Why it happens
Strong CYP3A4 and P-gp inhibition increases drug exposure, combined with additive QT prolongation.
What to do
Prefer an alternative antibiotic such as azithromycin, noting its own QT effect, or doxycycline where suitable. If used, monitor ECG, potassium and for systemic steroid effects.
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 Fluticasone-vilanterol
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-vilanterol?
MediHelp rates the interaction as major. Clarithromycin and Fluticasone-vilanterol 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 prolongs the QT interval and strongly inhibits CYP3A4, which can raise vilanterol and fluticasone furoate exposure. This increases the risk of cardiovascular beta-agonist effects and systemic corticosteroid effects.
How serious is the interaction between Clarithromycin and Fluticasone-vilanterol?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Prefer an alternative antibiotic such as azithromycin, noting its own QT effect, or doxycycline where suitable. If used, monitor ECG, potassium and for systemic steroid effects.
What other medicines interact with Fluticasone-vilanterol?
MediHelp also lists interactions of Fluticasone-vilanterol with, for example, Adagrasib, Amiodarone, Amisulpride. The full list is on the Fluticasone-vilanterol page.
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