Drug interactions
Clarithromycin + Metformin-repaglinide
Severity: Major
Clarithromycin and Metformin-repaglinide: 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 raises repaglinide exposure, increasing the risk of hypoglycemia. Hypoglycemia has been observed with this combination.
What this interaction means in plain words
Clarithromycin and Metformin-repaglinide 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; Metformin-repaglinide belongs to Endocrine.
Why it happens
Inhibition of CYP3A4-mediated repaglinide metabolism by clarithromycin.
What to do
Use an alternative antibiotic such as azithromycin if possible. Otherwise reduce repaglinide dose and monitor blood glucose frequently.
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 Metformin-repaglinide
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 Metformin-repaglinide?
MediHelp rates the interaction as major. Clarithromycin and Metformin-repaglinide 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 raises repaglinide exposure, increasing the risk of hypoglycemia. Hypoglycemia has been observed with this combination.
How serious is the interaction between Clarithromycin and Metformin-repaglinide?
MediHelp rates it major, 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 possible. Otherwise reduce repaglinide dose and monitor blood glucose frequently.
What other medicines interact with Metformin-repaglinide?
MediHelp also lists interactions of Metformin-repaglinide with, for example, Gemfibrozil, Apalutamide, Clopidogrel. The full list is on the Metformin-repaglinide page.
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