Drug interactions
Clarithromycin + Imatinib
Severity: Major
Clarithromycin and Imatinib: 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 can raise imatinib exposure, increasing the risk of adverse effects such as fluid retention, nausea, myelosuppression and hepatotoxicity. Imatinib is also a CYP3A4 inhibitor and may in turn raise clarithromycin levels.
What this interaction means in plain words
Clarithromycin and Imatinib 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; Imatinib belongs to Oncology.
Why it happens
Clarithromycin inhibits CYP3A4 and P-glycoprotein, reducing imatinib clearance.
What to do
Use an alternative antibiotic such as azithromycin if feasible. Otherwise monitor blood counts, liver tests and for imatinib toxicity, and reduce the imatinib dose if needed.
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 Imatinib
- Imatinib + Lomitapide Contraindicated
- Imatinib + Lonafarnib Contraindicated
- Amobarbital + Imatinib Major
- Apalutamide + Imatinib Major
- Avapritinib + Imatinib Major
- Benzhydrocodone / acetaminophen + Imatinib Major
Frequently asked questions
Can I take Clarithromycin with Imatinib?
MediHelp rates the interaction as major. Clarithromycin and Imatinib 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 can raise imatinib exposure, increasing the risk of adverse effects such as fluid retention, nausea, myelosuppression and hepatotoxicity. Imatinib is also a CYP3A4 inhibitor and may in turn raise clarithromycin levels.
How serious is the interaction between Clarithromycin and Imatinib?
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 such as azithromycin if feasible. Otherwise monitor blood counts, liver tests and for imatinib toxicity, and reduce the imatinib dose if needed.
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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