Drug interactions
Clarithromycin + Omeprazole
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.
Overview
Clarithromycin can increase omeprazole plasma exposure via CYP inhibition, which may enhance acid suppression; this is commonly leveraged in H. pylori regimens.
Mechanism of action
Pharmacokinetic: Clarithromycin inhibits CYP3A4 (and to a lesser extent CYP2C19); omeprazole is metabolized by CYP2C19 and CYP3A4, so omeprazole clearance is reduced.
Clinical management
No routine dose adjustment required; monitor for increased PPI adverse effects (e.g., headache, diarrhea). If therapy is prolonged, monitor for hypomagnesemia and vitamin B12 deficiency.
Drug reference
References
- Omeprazole (Prilosec) Prescribing Information – Drug Interactions — FDA Label
- Clarithromycin (Biaxin) Prescribing Information – Drug Interactions — FDA Label
- Omeprazole: Drug Interactions — Lexicomp
Frequently asked questions
Can I take Clarithromycin with Omeprazole?
The interaction is rated: Moderate. Clarithromycin can increase omeprazole plasma exposure via CYP inhibition, which may enhance acid suppression; this is commonly leveraged in H. pylori regimens.
How serious is the interaction between Clarithromycin and Omeprazole?
The interaction is rated: Moderate. Evidence level: High.
How is the interaction between Clarithromycin and Omeprazole managed?
No routine dose adjustment required; monitor for increased PPI adverse effects (e.g., headache, diarrhea). If therapy is prolonged, monitor for hypomagnesemia and vitamin B12 deficiency.
Why do Clarithromycin and Omeprazole interact?
Pharmacokinetic: Clarithromycin inhibits CYP3A4 (and to a lesser extent CYP2C19); omeprazole is metabolized by CYP2C19 and CYP3A4, so omeprazole clearance is reduced.
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