Drug interactions
Clarithromycin + Hydrocodone
Severity: Major
Clarithromycin and Hydrocodone: major interaction.
Last updated Sources: US FDA label
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 strongly inhibits CYP3A4 and can raise hydrocodone concentrations, increasing sedation and the risk of life-threatening respiratory depression. Effects may be more pronounced in the first days and persist after the antibiotic is stopped.
What this interaction means in plain words
Clarithromycin and Hydrocodone 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; Hydrocodone belongs to Musculoskeletal.
Why it happens
CYP3A4 inhibition by clarithromycin reduces hydrocodone clearance.
What to do
Consider an alternative antibiotic such as azithromycin or reduce the hydrocodone dose with close monitoring of sedation and breathing. Re-evaluate the dose when clarithromycin is stopped.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Clarithromycin and Hydrocodone, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
References
Other interactions of Hydrocodone
- Alvimopan + Hydrocodone Contraindicated
- Bupropion-naltrexone + Hydrocodone Contraindicated
- Hydrocodone + Isocarboxazid Contraindicated
- Hydrocodone + Olanzapine / samidorphan Contraindicated
- Hydrocodone + Phenelzine Contraindicated
- Alfentanil + Hydrocodone Major
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 Hydrocodone?
MediHelp rates the interaction as major. Clarithromycin and Hydrocodone 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 strongly inhibits CYP3A4 and can raise hydrocodone concentrations, increasing sedation and the risk of life-threatening respiratory depression. Effects may be more pronounced in the first days and persist after the antibiotic is stopped.
How serious is the interaction between Clarithromycin and Hydrocodone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Consider an alternative antibiotic such as azithromycin or reduce the hydrocodone dose with close monitoring of sedation and breathing. Re-evaluate the dose when clarithromycin is stopped.
What other medicines interact with Hydrocodone?
MediHelp also lists interactions of Hydrocodone with, for example, Alvimopan, Bupropion-naltrexone, Isocarboxazid. The full list is on the Hydrocodone page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
