Drug interactions
Clarithromycin + Gliclazide
Severity: Major
Clarithromycin and Gliclazide: 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 has been associated with hypoglycemia in patients taking sulfonylureas, sometimes severe. Elderly patients and those with renal impairment are particularly vulnerable.
What this interaction means in plain words
Clarithromycin and Gliclazide 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; Gliclazide belongs to Endocrine.
Why it happens
Clarithromycin may raise sulfonylurea exposure by inhibiting metabolism and may stimulate insulin release; the exact mechanism is incompletely defined.
What to do
Monitor blood glucose closely, or choose a non-macrolide antibiotic where possible. Reduce the gliclazide dose if the combination is essential.
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 Gliclazide
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 Gliclazide?
MediHelp rates the interaction as major. Clarithromycin and Gliclazide 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 has been associated with hypoglycemia in patients taking sulfonylureas, sometimes severe. Elderly patients and those with renal impairment are particularly vulnerable.
How serious is the interaction between Clarithromycin and Gliclazide?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor blood glucose closely, or choose a non-macrolide antibiotic where possible. Reduce the gliclazide dose if the combination is essential.
What other medicines interact with Gliclazide?
MediHelp also lists interactions of Gliclazide with, for example, Ciprofloxacin, Disopyramide, Fluconazole. The full list is on the Gliclazide page.
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