Drug interactions
Clarithromycin + Repaglinide
Severity: Major
Clarithromycin and Repaglinide: 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
Clarithromycin increases repaglinide exposure, which can lead to prolonged or severe hypoglycemia. The interaction is clinically meaningful.
What this interaction means in plain words
Clarithromycin and Repaglinide 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; Repaglinide belongs to Endocrine.
Why it happens
Clarithromycin inhibits CYP3A4 (and possibly OATP1B1), decreasing repaglinide clearance.
What to do
Monitor blood glucose closely and reduce the repaglinide dose if needed; prefer a non-interacting antibiotic. Warn patients about hypoglycemia symptoms.
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 Repaglinide
- Gemfibrozil + Repaglinide Contraindicated
- Clopidogrel + Repaglinide Major
- Cobicistat + Repaglinide Major
- Cyclosporine + Repaglinide Major
- Cyclosporin + Repaglinide Major
- Deferasirox + Repaglinide Major
Frequently asked questions
Can I take Clarithromycin with Repaglinide?
MediHelp rates the interaction as major. Clarithromycin and Repaglinide 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 increases repaglinide exposure, which can lead to prolonged or severe hypoglycemia. The interaction is clinically meaningful.
How serious is the interaction between Clarithromycin and Repaglinide?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor blood glucose closely and reduce the repaglinide dose if needed; prefer a non-interacting antibiotic. Warn patients about hypoglycemia symptoms.
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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