Drug interactions
Clarithromycin + Liposomal doxorubicin
Severity: Moderate
Clarithromycin and Liposomal doxorubicin: 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 inhibits CYP3A4 and P-glycoprotein and may raise doxorubicin exposure. This could increase myelosuppression, mucositis and cardiotoxicity. Clarithromycin also prolongs the QT interval, which adds to cardiac concern.
What this interaction means in plain words
Clarithromycin and Liposomal doxorubicin 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; Liposomal doxorubicin belongs to Oncology.
Why it happens
Clarithromycin inhibits CYP3A4 and P-glycoprotein, reducing doxorubicin clearance.
What to do
Use an alternative antibiotic such as azithromycin if clinically suitable. Otherwise monitor blood counts, ECG and signs of anthracycline toxicity.
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 Liposomal doxorubicin
- Dengue vaccine + Liposomal doxorubicin Contraindicated
- Belatacept + Liposomal doxorubicin Major
- Cyclosporine + Liposomal doxorubicin Major
- Dronedarone + Liposomal doxorubicin Major
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Liposomal doxorubicin Major
- Fingolimod + Liposomal doxorubicin Major
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 Liposomal doxorubicin?
MediHelp rates the interaction as moderate. Clarithromycin and Liposomal doxorubicin 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 inhibits CYP3A4 and P-glycoprotein and may raise doxorubicin exposure. This could increase myelosuppression, mucositis and cardiotoxicity. Clarithromycin also prolongs the QT interval, which adds to cardiac concern.
How serious is the interaction between Clarithromycin and Liposomal doxorubicin?
MediHelp rates it moderate, 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 clinically suitable. Otherwise monitor blood counts, ECG and signs of anthracycline toxicity.
What other medicines interact with Liposomal doxorubicin?
MediHelp also lists interactions of Liposomal doxorubicin with, for example, Dengue vaccine, Belatacept, Cyclosporine. The full list is on the Liposomal doxorubicin page.
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