Drug interactions
Clarithromycin + Fluvoxamine
Severity: Moderate
Clarithromycin and Fluvoxamine: 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
Both agents have been associated with QT prolongation, and combined use increases the risk of arrhythmia, particularly with electrolyte disturbance or heart disease. Fluvoxamine inhibits several CYP enzymes and clarithromycin inhibits CYP3A4, which may raise the concentrations of other co-prescribed drugs.
What this interaction means in plain words
Clarithromycin and Fluvoxamine 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.
Clarithromycin belongs to Anti Bacterial; Fluvoxamine belongs to Central Nervous System.
Why it happens
Additive QT interval prolongation, with overlapping CYP inhibition.
What to do
Obtain an ECG and correct potassium and magnesium in at-risk patients; prefer a non-QT-prolonging antibiotic when feasible.
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
Other interactions of Fluvoxamine
- Agomelatine + Fluvoxamine Contraindicated
- Alosetron + Fluvoxamine Contraindicated
- Fezolinetant + Fluvoxamine Contraindicated
- Fluvoxamine + Isocarboxazid Contraindicated
- Fluvoxamine + Mavacamten Contraindicated
- Fluvoxamine + Methylene blue Contraindicated
Frequently asked questions
Can I take Clarithromycin with Fluvoxamine?
MediHelp rates the interaction as moderate. Clarithromycin and Fluvoxamine 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. Both agents have been associated with QT prolongation, and combined use increases the risk of arrhythmia, particularly with electrolyte disturbance or heart disease. Fluvoxamine inhibits several CYP enzymes and clarithromycin inhibits CYP3A4, which may raise the concentrations of other co-prescribed drugs.
How serious is the interaction between Clarithromycin and Fluvoxamine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Obtain an ECG and correct potassium and magnesium in at-risk patients; prefer a non-QT-prolonging antibiotic when feasible.
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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