Drug interactions
Clarithromycin + Ramelteon
Severity: Moderate
Clarithromycin and Ramelteon: 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
Ramelteon is partly metabolized by CYP3A4, and clarithromycin may increase its exposure. This could cause greater next-day sedation or dizziness.
What this interaction means in plain words
Clarithromycin and Ramelteon 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; Ramelteon belongs to Central Nervous System.
Why it happens
Inhibition of CYP3A4 by clarithromycin reduces ramelteon clearance.
What to do
Monitor for excessive sedation and consider a lower ramelteon dose or an alternative antibiotic during co-therapy.
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 Ramelteon
- Calcium / magnesium / potassium / sodium oxybates + Ramelteon Contraindicated
- Fluvoxamine + Ramelteon Contraindicated
- Ramelteon + Sodium oxybate Contraindicated
- Alfentanil + Ramelteon Moderate
- Amitriptyline + Ramelteon Moderate
- Amobarbital + Ramelteon Moderate
Frequently asked questions
Can I take Clarithromycin with Ramelteon?
MediHelp rates the interaction as moderate. Clarithromycin and Ramelteon 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. Ramelteon is partly metabolized by CYP3A4, and clarithromycin may increase its exposure. This could cause greater next-day sedation or dizziness.
How serious is the interaction between Clarithromycin and Ramelteon?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for excessive sedation and consider a lower ramelteon dose or an alternative antibiotic during co-therapy.
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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