Drug interactions
Clarithromycin + Lumacaftor / ivacaftor
Severity: Moderate
Clarithromycin and Lumacaftor / ivacaftor: 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
Lumacaftor is a strong CYP3A inducer and can lower clarithromycin exposure, potentially causing loss of antibacterial efficacy. Ivacaftor exposure may also rise modestly with clarithromycin, though the induction effect predominates overall.
What this interaction means in plain words
Clarithromycin and Lumacaftor / ivacaftor 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.
Why it happens
Lumacaftor induces CYP3A4 and increases clarithromycin clearance, reducing its plasma levels.
What to do
Consider an alternative antibiotic such as azithromycin, which is less dependent on CYP3A, when a macrolide is needed. If clarithromycin is used, monitor clinical response closely.
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
Frequently asked questions
Can I take Clarithromycin with Lumacaftor / ivacaftor?
MediHelp rates the interaction as moderate. Clarithromycin and Lumacaftor / ivacaftor 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. Lumacaftor is a strong CYP3A inducer and can lower clarithromycin exposure, potentially causing loss of antibacterial efficacy. Ivacaftor exposure may also rise modestly with clarithromycin, though the induction effect predominates overall.
How serious is the interaction between Clarithromycin and Lumacaftor / ivacaftor?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Consider an alternative antibiotic such as azithromycin, which is less dependent on CYP3A, when a macrolide is needed. If clarithromycin is used, monitor clinical response closely.
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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