Drug interactions
Clarithromycin + Nimodipine
Severity: Major
Clarithromycin and Nimodipine: 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 may substantially increase nimodipine levels, causing hypotension, which is especially concerning in patients with subarachnoid hemorrhage. Edema, bradycardia and renal impairment from low perfusion may also occur.
What this interaction means in plain words
Clarithromycin and Nimodipine 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; Nimodipine belongs to Cardiovascular.
Why it happens
Clarithromycin inhibits CYP3A4-mediated first-pass and systemic metabolism of nimodipine.
What to do
Avoid the combination if possible and choose a non-CYP3A4-inhibiting antibiotic. If unavoidable, monitor blood pressure closely and reduce the nimodipine dose or split dosing.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Clarithromycin and Nimodipine, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 14 days on the web. No card needed.
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 Nimodipine
- Apalutamide + Nimodipine Major
- Carbamazepine + Nimodipine Major
- Ceritinib + Nimodipine Major
- Cobicistat + Nimodipine Major
- Darunavir + Nimodipine Major
- Duvelisib + Nimodipine Major
Frequently asked questions
Can I take Clarithromycin with Nimodipine?
MediHelp rates the interaction as major. Clarithromycin and Nimodipine 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 may substantially increase nimodipine levels, causing hypotension, which is especially concerning in patients with subarachnoid hemorrhage. Edema, bradycardia and renal impairment from low perfusion may also occur.
How serious is the interaction between Clarithromycin and Nimodipine?
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 the combination if possible and choose a non-CYP3A4-inhibiting antibiotic. If unavoidable, monitor blood pressure closely and reduce the nimodipine dose or split dosing.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
