Drug interactions
Clarithromycin + Nevirapine
Severity: Moderate
Clarithromycin and Nevirapine: 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
Nevirapine induces CYP3A4 and lowers clarithromycin concentrations while increasing the active 14-hydroxy metabolite. Clarithromycin efficacy may be reduced, particularly for mycobacterial infections, and nevirapine levels may rise modestly.
What this interaction means in plain words
Clarithromycin and Nevirapine 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; Nevirapine belongs to Anti Virals.
Why it happens
Nevirapine induces CYP3A4, accelerating clarithromycin metabolism and altering the parent-to-metabolite ratio.
What to do
Consider azithromycin as an alternative, particularly for Mycobacterium avium complex. If clarithromycin is needed, monitor clinical response and for rash and hepatotoxicity.
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 Nevirapine
- Elbasvir / grazoprevir + Nevirapine Contraindicated
- Nevirapine + Ranolazine Contraindicated
- Nevirapine + St john's wort Contraindicated
- Abemaciclib + Nevirapine Major
- Acalabrutinib + Nevirapine Major
- Amobarbital + Nevirapine Major
Frequently asked questions
Can I take Clarithromycin with Nevirapine?
MediHelp rates the interaction as moderate. Clarithromycin and Nevirapine 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. Nevirapine induces CYP3A4 and lowers clarithromycin concentrations while increasing the active 14-hydroxy metabolite. Clarithromycin efficacy may be reduced, particularly for mycobacterial infections, and nevirapine levels may rise modestly.
How serious is the interaction between Clarithromycin and Nevirapine?
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 azithromycin as an alternative, particularly for Mycobacterium avium complex. If clarithromycin is needed, monitor clinical response and for rash and hepatotoxicity.
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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