Drug interactions
Clarithromycin + Nateglinide
Severity: Moderate
Clarithromycin and Nateglinide: 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
Nateglinide is partly metabolized by CYP3A4, so clarithromycin could raise its levels and enhance glucose lowering. Macrolides have also been associated with hypoglycemia in patients taking insulin secretagogues.
What this interaction means in plain words
Clarithromycin and Nateglinide 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; Nateglinide belongs to Endocrine.
Why it happens
Inhibition of CYP3A4 reduces nateglinide metabolism, raising exposure and hypoglycemic effect.
What to do
Monitor blood glucose closely during and after the clarithromycin course. Counsel the patient on hypoglycemia symptoms and reduce the nateglinide dose if needed.
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 Nateglinide
- Albiglutide + Nateglinide Moderate
- Alogliptin-metformin + Nateglinide Moderate
- Alogliptin-pioglitazone + Nateglinide Moderate
- Alogliptin + Nateglinide Moderate
- Alpelisib + Nateglinide Moderate
- Amiodarone + Nateglinide Moderate
Frequently asked questions
Can I take Clarithromycin with Nateglinide?
MediHelp rates the interaction as moderate. Clarithromycin and Nateglinide 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. Nateglinide is partly metabolized by CYP3A4, so clarithromycin could raise its levels and enhance glucose lowering. Macrolides have also been associated with hypoglycemia in patients taking insulin secretagogues.
How serious is the interaction between Clarithromycin and Nateglinide?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor blood glucose closely during and after the clarithromycin course. Counsel the patient on hypoglycemia symptoms and reduce the nateglinide dose if needed.
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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