Drug interactions
Clarithromycin + Lopinavir
Severity: Major
Clarithromycin and Lopinavir: 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 and lopinavir/ritonavir can raise each other's concentrations through CYP3A4 inhibition, and both prolong the QT interval. This increases the risk of arrhythmia and adverse effects.
What this interaction means in plain words
Clarithromycin and Lopinavir 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; Lopinavir belongs to Anti Virals.
Why it happens
Mutual CYP3A4 inhibition with additive QT prolongation.
What to do
Reduce the clarithromycin dose in renal impairment and monitor ECG and electrolytes. Consider azithromycin as an alternative.
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 Lopinavir
- Alfuzosin + Lopinavir Contraindicated
- Avanafil + Lopinavir Contraindicated
- Cisapride + Lopinavir Contraindicated
- Dronedarone + Lopinavir Contraindicated
- Eletriptan + Lopinavir Contraindicated
- Eplerenone + Lopinavir Contraindicated
Frequently asked questions
Can I take Clarithromycin with Lopinavir?
MediHelp rates the interaction as major. Clarithromycin and Lopinavir 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 and lopinavir/ritonavir can raise each other's concentrations through CYP3A4 inhibition, and both prolong the QT interval. This increases the risk of arrhythmia and adverse effects.
How serious is the interaction between Clarithromycin and Lopinavir?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reduce the clarithromycin dose in renal impairment and monitor ECG and electrolytes. Consider azithromycin as an alternative.
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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