Drug interactions
Clarithromycin + Hydroxychloroquine
Severity: Major
Clarithromycin and Hydroxychloroquine: 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
Both agents prolong the QT interval, and clarithromycin is a known cause of torsades de pointes. Combined use increases the risk of serious ventricular arrhythmia, especially in patients with cardiac disease or electrolyte abnormalities.
What this interaction means in plain words
Clarithromycin and Hydroxychloroquine 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; Hydroxychloroquine belongs to Musculoskeletal.
Why it happens
Additive QT prolongation through cardiac potassium channel blockade; clarithromycin may also inhibit CYP3A4 and raise hydroxychloroquine exposure.
What to do
Use an alternative antibiotic with less QT effect, such as doxycycline where appropriate. If unavoidable, check a baseline ECG, correct potassium and magnesium and monitor the QTc.
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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References
Other interactions of Hydroxychloroquine
- Arsenic trioxide + Hydroxychloroquine Contraindicated
- Cisapride + Hydroxychloroquine Contraindicated
- Dronedarone + Hydroxychloroquine Contraindicated
- Hydroxychloroquine + Pimozide Contraindicated
- Hydroxychloroquine + Thioridazine Contraindicated
- Hydroxychloroquine + Vandetanib Contraindicated
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 Hydroxychloroquine?
MediHelp rates the interaction as major. Clarithromycin and Hydroxychloroquine 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. Both agents prolong the QT interval, and clarithromycin is a known cause of torsades de pointes. Combined use increases the risk of serious ventricular arrhythmia, especially in patients with cardiac disease or electrolyte abnormalities.
How serious is the interaction between Clarithromycin and Hydroxychloroquine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use an alternative antibiotic with less QT effect, such as doxycycline where appropriate. If unavoidable, check a baseline ECG, correct potassium and magnesium and monitor the QTc.
What other medicines interact with Hydroxychloroquine?
MediHelp also lists interactions of Hydroxychloroquine with, for example, Arsenic trioxide, Cisapride, Dronedarone. The full list is on the Hydroxychloroquine page.
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