Drug interactions
Clarithromycin + Nefazodone
Severity: Major
Clarithromycin and Nefazodone: 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
Both drugs inhibit CYP3A4 and are substrates of it, so each can raise the other's concentrations. This may lead to QT prolongation, excess serotonergic effects, or clarithromycin toxicity.
What this interaction means in plain words
Clarithromycin and Nefazodone 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.
Why it happens
Mutual CYP3A4 inhibition reduces clearance of both drugs.
What to do
Avoid combining them and use an alternative antibiotic such as azithromycin or a different antidepressant. If unavoidable, monitor for adverse effects and ECG changes.
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 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 Nefazodone?
MediHelp rates the interaction as major. Clarithromycin and Nefazodone 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. Both drugs inhibit CYP3A4 and are substrates of it, so each can raise the other's concentrations. This may lead to QT prolongation, excess serotonergic effects, or clarithromycin toxicity.
How serious is the interaction between Clarithromycin and Nefazodone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid combining them and use an alternative antibiotic such as azithromycin or a different antidepressant. If unavoidable, monitor for adverse effects and ECG changes.
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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