Drug interactions
Clarithromycin + Lacosamide
Severity: Moderate
Clarithromycin and Lacosamide: moderate 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 may increase lacosamide exposure because CYP3A4 contributes to its metabolism, though the effect is usually small. Increased dizziness, PR-interval prolongation and conduction problems are possible, mainly in patients with renal or hepatic impairment or heart disease.
What this interaction means in plain words
Clarithromycin and Lacosamide can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Clarithromycin belongs to Anti Bacterial; Lacosamide belongs to Central Nervous System.
Why it happens
Clarithromycin inhibits CYP3A4, one of several pathways (with CYP2C19 and CYP2C9) that metabolize lacosamide.
What to do
Monitor for dizziness, ataxia and ECG changes, especially in patients with renal or hepatic impairment, and reduce the lacosamide dose if adverse effects emerge.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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
Other interactions of Lacosamide
- Lacosamide + Zuranolone Major
- Atazanavir + Lacosamide Moderate
- Carbamazepine + Lacosamide Moderate
- Cenobamate + Lacosamide Moderate
- Daridorexant + Lacosamide Moderate
- Eslicarbazepine + Lacosamide Moderate
Frequently asked questions
Can I take Clarithromycin with Lacosamide?
MediHelp rates the interaction as moderate. Clarithromycin and Lacosamide can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Clarithromycin may increase lacosamide exposure because CYP3A4 contributes to its metabolism, though the effect is usually small. Increased dizziness, PR-interval prolongation and conduction problems are possible, mainly in patients with renal or hepatic impairment or heart disease.
How serious is the interaction between Clarithromycin and Lacosamide?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for dizziness, ataxia and ECG changes, especially in patients with renal or hepatic impairment, and reduce the lacosamide dose if adverse effects emerge.
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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