Drug interactions
Clarithromycin + Ibrutinib
Severity: Major
Clarithromycin and Ibrutinib: 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 is a strong CYP3A4 inhibitor and can greatly increase ibrutinib exposure. Higher ibrutinib levels raise the risk of bleeding, infection, cytopenias, and cardiac arrhythmias such as atrial fibrillation.
What this interaction means in plain words
Clarithromycin and Ibrutinib 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; Ibrutinib belongs to Oncology.
Why it happens
Strong inhibition of CYP3A4 by clarithromycin reduces first-pass and systemic metabolism of ibrutinib.
What to do
Prefer an antibiotic that does not inhibit CYP3A4. If clarithromycin is needed, reduce the ibrutinib dose according to labeling or interrupt it for the antibiotic course, and monitor for toxicity.
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 Clarithromycin
- Astemizole + Clarithromycin Contraindicated
- Avanafil + Clarithromycin Contraindicated
- Cisapride + Clarithromycin Contraindicated
- Clarithromycin + Colchicine Contraindicated
- Clarithromycin + Conivaptan Contraindicated
- Clarithromycin + Dihydroergotamine Contraindicated
Other interactions of Ibrutinib
- Abciximab + Ibrutinib Major
- Acetylsalicylic acid + Ibrutinib Major
- Alteplase + Ibrutinib Major
- Amobarbital + Ibrutinib Major
- Apalutamide + Ibrutinib Major
- Apixaban + Ibrutinib Major
Frequently asked questions
Can I take Clarithromycin with Ibrutinib?
MediHelp rates the interaction as major. Clarithromycin and Ibrutinib 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 is a strong CYP3A4 inhibitor and can greatly increase ibrutinib exposure. Higher ibrutinib levels raise the risk of bleeding, infection, cytopenias, and cardiac arrhythmias such as atrial fibrillation.
How serious is the interaction between Clarithromycin and Ibrutinib?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Prefer an antibiotic that does not inhibit CYP3A4. If clarithromycin is needed, reduce the ibrutinib dose according to labeling or interrupt it for the antibiotic course, and monitor for toxicity.
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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