Drug interactions
Clarithromycin + Glyburide
Severity: Major
Clarithromycin and Glyburide: 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 linked to severe hypoglycemia in patients taking glyburide, especially older adults and those with renal dysfunction. Clarithromycin may also increase glyburide exposure by inhibiting transport and metabolism.
What this interaction means in plain words
Clarithromycin and Glyburide 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; Glyburide belongs to Endocrine.
Why it happens
Clarithromycin may inhibit CYP3A4 and OATP/P-glycoprotein handling of glyburide, while also enhancing insulin secretion.
What to do
Avoid the combination if possible or use azithromycin instead. If used together, monitor blood glucose frequently and reduce the glyburide dose.
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 Clarithromycin
- Astemizole + Clarithromycin Contraindicated
- Avanafil + Clarithromycin Contraindicated
- Cisapride + Clarithromycin Contraindicated
- Clarithromycin + Colchicine Contraindicated
- Clarithromycin + Conivaptan Contraindicated
- Clarithromycin + Dihydroergotamine Contraindicated
Other interactions of Glyburide
- Bosentan + Glyburide Contraindicated
- Cholic acid + Glyburide Major
- Ciprofloxacin + Glyburide Major
- Fluconazole + Glyburide Major
- Glyburide + Insulin degludec-liraglutide Major
- Glyburide + Miconazole Major
Frequently asked questions
Can I take Clarithromycin with Glyburide?
MediHelp rates the interaction as major. Clarithromycin and Glyburide 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 linked to severe hypoglycemia in patients taking glyburide, especially older adults and those with renal dysfunction. Clarithromycin may also increase glyburide exposure by inhibiting transport and metabolism.
How serious is the interaction between Clarithromycin and Glyburide?
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 if possible or use azithromycin instead. If used together, monitor blood glucose frequently and reduce the glyburide dose.
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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