Drug interactions
Clarithromycin + Nifedipine
Severity: Major
Clarithromycin and Nifedipine: 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 raises nifedipine exposure and can cause marked hypotension, peripheral edema and reflex effects. Observational data link this combination to hypotension and acute kidney injury, particularly in older adults.
What this interaction means in plain words
Clarithromycin and Nifedipine 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; Nifedipine belongs to Cardiovascular.
Why it happens
Clarithromycin inhibits CYP3A4 and intestinal first-pass metabolism of nifedipine.
What to do
Prefer azithromycin or another non-CYP3A4-inhibiting antibiotic. If combined, start nifedipine at the lowest dose and monitor blood pressure and renal function.
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
Other interactions of Nifedipine
Frequently asked questions
Can I take Clarithromycin with Nifedipine?
MediHelp rates the interaction as major. Clarithromycin and Nifedipine 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 raises nifedipine exposure and can cause marked hypotension, peripheral edema and reflex effects. Observational data link this combination to hypotension and acute kidney injury, particularly in older adults.
How serious is the interaction between Clarithromycin and Nifedipine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Prefer azithromycin or another non-CYP3A4-inhibiting antibiotic. If combined, start nifedipine at the lowest dose and monitor blood pressure and renal function.
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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