Drug interactions
Clarithromycin + Nirmatrelvir
Severity: Moderate
Clarithromycin and Nirmatrelvir: 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
Nirmatrelvir can raise clarithromycin concentrations, increasing the risk of adverse effects including QT prolongation, particularly in renal impairment.
What this interaction means in plain words
Clarithromycin and Nirmatrelvir 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; Nirmatrelvir belongs to Anti Virals.
Why it happens
Inhibition of CYP3A4 and P-gp reduces clarithromycin clearance.
What to do
Reduce clarithromycin dose in renal impairment (e.g., CrCl below 30 mL/min) and monitor for adverse effects and QT prolongation.
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 Nirmatrelvir
- Alfuzosin + Nirmatrelvir Contraindicated
- Amiodarone + Nirmatrelvir Contraindicated
- Apalutamide + Nirmatrelvir Contraindicated
- Carbamazepine + Nirmatrelvir Contraindicated
- Colchicine + Nirmatrelvir Contraindicated
- Dronedarone + Nirmatrelvir Contraindicated
Frequently asked questions
Can I take Clarithromycin with Nirmatrelvir?
MediHelp rates the interaction as moderate. Clarithromycin and Nirmatrelvir 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. Nirmatrelvir can raise clarithromycin concentrations, increasing the risk of adverse effects including QT prolongation, particularly in renal impairment.
How serious is the interaction between Clarithromycin and Nirmatrelvir?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reduce clarithromycin dose in renal impairment (e.g., CrCl below 30 mL/min) and monitor for adverse effects and QT prolongation.
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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