Drug interactions
Clarithromycin + Panobinostat
Severity: Major
Clarithromycin and Panobinostat: major interaction.
Last updated Sources: EMA SmPC
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 prolong the QT interval, and clarithromycin may also raise panobinostat concentrations. This increases the risk of torsades de pointes and sudden cardiac death.
What this interaction means in plain words
Clarithromycin and Panobinostat 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; Panobinostat belongs to Oncology.
Why it happens
Additive QTc prolongation, with CYP3A4 inhibition by clarithromycin increasing panobinostat exposure.
What to do
Avoid the combination and use a non-QT-prolonging antibiotic. If a strong CYP3A inhibitor is unavoidable, reduce the panobinostat dose per labeling and monitor ECG and electrolytes.
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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References
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 Panobinostat
- Amiodarone + Panobinostat Contraindicated
- Anagrelide + Panobinostat Contraindicated
- Chloroquine + Panobinostat Contraindicated
- Chlorpromazine + Panobinostat Contraindicated
- Dronedarone + Panobinostat Contraindicated
- Haloperidol + Panobinostat Contraindicated
Frequently asked questions
Can I take Clarithromycin with Panobinostat?
MediHelp rates the interaction as major. Clarithromycin and Panobinostat 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. Both drugs prolong the QT interval, and clarithromycin may also raise panobinostat concentrations. This increases the risk of torsades de pointes and sudden cardiac death.
How serious is the interaction between Clarithromycin and Panobinostat?
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 and use a non-QT-prolonging antibiotic. If a strong CYP3A inhibitor is unavoidable, reduce the panobinostat dose per labeling and monitor ECG and electrolytes.
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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