Drug interactions
Clarithromycin + Fluticasone
Severity: Major
Clarithromycin and Fluticasone: major 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 is a strong CYP3A4 inhibitor and can markedly raise systemic fluticasone exposure. This has led to Cushing syndrome and adrenal suppression, mainly with prolonged use.
What this interaction means in plain words
Clarithromycin and Fluticasone 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 belongs to Respiratory.
Why it happens
Strong CYP3A4 inhibition by clarithromycin decreases first-pass and systemic clearance of fluticasone.
What to do
Avoid the combination in long-term therapy; consider an alternative antibiotic such as azithromycin or a corticosteroid less dependent on CYP3A4, such as beclometasone. If a short course is unavoidable, monitor for Cushingoid features and adrenal suppression.
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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Other interactions of Fluticasone
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?
MediHelp rates the interaction as major. Clarithromycin and Fluticasone 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 is a strong CYP3A4 inhibitor and can markedly raise systemic fluticasone exposure. This has led to Cushing syndrome and adrenal suppression, mainly with prolonged use.
How serious is the interaction between Clarithromycin and Fluticasone?
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 the combination in long-term therapy; consider an alternative antibiotic such as azithromycin or a corticosteroid less dependent on CYP3A4, such as beclometasone. If a short course is unavoidable, monitor for Cushingoid features and adrenal suppression.
What other medicines interact with Fluticasone?
MediHelp also lists interactions of Fluticasone with, for example, Atazanavir, Cobicistat, Darunavir. The full list is on the Fluticasone page.
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