Drug interactions
Clarithromycin + Quinupristin / dalfopristin
Severity: Major
Clarithromycin and Quinupristin / dalfopristin: 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
Quinupristin/dalfopristin inhibits CYP3A4 and may raise clarithromycin exposure, with both agents potentially affecting cardiac repolarization. This could increase the risk of QT prolongation and macrolide adverse effects. Clinical data are limited and the combination is rarely needed.
What this interaction means in plain words
Clarithromycin and Quinupristin / dalfopristin 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.
Why it happens
CYP3A4 inhibition by dalfopristin/quinupristin reduces clarithromycin clearance, with possible additive QT effects.
What to do
Avoid the combination where alternatives exist. If both are used, monitor ECG and electrolytes and watch for macrolide toxicity.
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
Frequently asked questions
Can I take Clarithromycin with Quinupristin / dalfopristin?
MediHelp rates the interaction as major. Clarithromycin and Quinupristin / dalfopristin 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. Quinupristin/dalfopristin inhibits CYP3A4 and may raise clarithromycin exposure, with both agents potentially affecting cardiac repolarization. This could increase the risk of QT prolongation and macrolide adverse effects. Clinical data are limited and the combination is rarely needed.
How serious is the interaction between Clarithromycin and Quinupristin / dalfopristin?
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 where alternatives exist. If both are used, monitor ECG and electrolytes and watch for macrolide toxicity.
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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