Drug interactions
Clarithromycin + Irinotecan liposomal
Severity: Major
Clarithromycin and Irinotecan liposomal: 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 inhibits CYP3A4 and P-gp, which can raise exposure to irinotecan and its active metabolite SN-38. This may worsen neutropenia and severe diarrhea.
What this interaction means in plain words
Clarithromycin and Irinotecan liposomal 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.
Why it happens
CYP3A4 and P-gp inhibition reduces irinotecan clearance and increases its exposure.
What to do
Avoid strong CYP3A4 inhibitors during irinotecan treatment and choose an alternative antibiotic. If unavoidable, monitor blood counts and for diarrhea.
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
Frequently asked questions
Can I take Clarithromycin with Irinotecan liposomal?
MediHelp rates the interaction as major. Clarithromycin and Irinotecan liposomal 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 inhibits CYP3A4 and P-gp, which can raise exposure to irinotecan and its active metabolite SN-38. This may worsen neutropenia and severe diarrhea.
How serious is the interaction between Clarithromycin and Irinotecan liposomal?
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 strong CYP3A4 inhibitors during irinotecan treatment and choose an alternative antibiotic. If unavoidable, monitor blood counts and for diarrhea.
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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