Drug interactions
Clarithromycin + Osilodrostat
Severity: Major
Clarithromycin and Osilodrostat: 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
Osilodrostat is partly metabolized by CYP3A4, so clarithromycin can raise exposure. Both drugs also prolong QT, increasing arrhythmia risk.
What this interaction means in plain words
Clarithromycin and Osilodrostat 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; Osilodrostat belongs to Endocrine.
Why it happens
CYP3A4 inhibition by clarithromycin reduces osilodrostat clearance, with additive QT prolongation.
What to do
Halve the osilodrostat dose during clarithromycin therapy and monitor ECG, potassium and magnesium. Choose a non-QT-prolonging antibiotic if possible, and monitor cortisol for hypocortisolism.
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 Osilodrostat
Frequently asked questions
Can I take Clarithromycin with Osilodrostat?
MediHelp rates the interaction as major. Clarithromycin and Osilodrostat 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. Osilodrostat is partly metabolized by CYP3A4, so clarithromycin can raise exposure. Both drugs also prolong QT, increasing arrhythmia risk.
How serious is the interaction between Clarithromycin and Osilodrostat?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Halve the osilodrostat dose during clarithromycin therapy and monitor ECG, potassium and magnesium. Choose a non-QT-prolonging antibiotic if possible, and monitor cortisol for hypocortisolism.
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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