Drug interactions
Clarithromycin + Nortriptyline
Severity: Moderate
Clarithromycin and Nortriptyline: 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
Both drugs can prolong the QT interval, and clarithromycin may also raise nortriptyline concentrations. Together they increase the risk of arrhythmia, anticholinergic effects and sedation.
What this interaction means in plain words
Clarithromycin and Nortriptyline 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; Nortriptyline belongs to Central Nervous System.
Why it happens
Additive QT prolongation plus CYP3A4 inhibition by clarithromycin that may reduce tricyclic clearance.
What to do
Obtain an ECG in patients with cardiac risk factors and monitor for tricyclic toxicity. Consider azithromycin or a non-macrolide antibiotic.
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 Nortriptyline
- Disopyramide + Nortriptyline Contraindicated
- Dofetilide + Nortriptyline Contraindicated
- Dronedarone + Nortriptyline Contraindicated
- Ibutilide + Nortriptyline Contraindicated
- Isocarboxazid + Nortriptyline Contraindicated
- Methylene blue + Nortriptyline Contraindicated
Frequently asked questions
Can I take Clarithromycin with Nortriptyline?
MediHelp rates the interaction as moderate. Clarithromycin and Nortriptyline 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. Both drugs can prolong the QT interval, and clarithromycin may also raise nortriptyline concentrations. Together they increase the risk of arrhythmia, anticholinergic effects and sedation.
How serious is the interaction between Clarithromycin and Nortriptyline?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Obtain an ECG in patients with cardiac risk factors and monitor for tricyclic toxicity. Consider azithromycin or a non-macrolide antibiotic.
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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