Drug interactions
Clarithromycin + Mitotane
Severity: Moderate
Clarithromycin and Mitotane: 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
Mitotane strongly induces CYP3A4 and can substantially lower clarithromycin concentrations, risking treatment failure. The induction effect persists for weeks after mitotane is stopped.
What this interaction means in plain words
Clarithromycin and Mitotane 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; Mitotane belongs to Oncology.
Why it happens
Mitotane induces CYP3A4, increasing clarithromycin metabolism.
What to do
Consider an antibiotic not dependent on CYP3A4, such as azithromycin or doxycycline for susceptible infections. If clarithromycin must be 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
Other interactions of Mitotane
- Doravirine + Mitotane Contraindicated
- Fostemsavir + Mitotane Contraindicated
- Lorlatinib + Mitotane Contraindicated
- Abiraterone + Mitotane Major
- Apixaban + Mitotane Major
- Aprepitant + Mitotane Major
Frequently asked questions
Can I take Clarithromycin with Mitotane?
MediHelp rates the interaction as moderate. Clarithromycin and Mitotane 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. Mitotane strongly induces CYP3A4 and can substantially lower clarithromycin concentrations, risking treatment failure. The induction effect persists for weeks after mitotane is stopped.
How serious is the interaction between Clarithromycin and Mitotane?
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 antibiotic not dependent on CYP3A4, such as azithromycin or doxycycline for susceptible infections. If clarithromycin must be 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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