Drug interactions
Clarithromycin + Ribociclib
Severity: Major
Clarithromycin and Ribociclib: major interaction.
Last updated Sources: US FDA label
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 raises ribociclib exposure and both drugs prolong the QT interval, so the risk of torsades de pointes is considerably increased. Ribociclib may also raise clarithromycin levels.
What this interaction means in plain words
Clarithromycin and Ribociclib 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; Ribociclib belongs to Oncology.
Why it happens
Mutual CYP3A4 inhibition combined with additive QT prolongation.
What to do
Avoid the combination and use a non-QT-prolonging antibiotic. If a strong CYP3A inhibitor is unavoidable, reduce ribociclib to 400 mg daily 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 Ribociclib
- Amiodarone + Ribociclib Contraindicated
- Cisapride + Ribociclib Contraindicated
- Dofetilide + Ribociclib Contraindicated
- Dronedarone + Ribociclib Contraindicated
- Flibanserin + Ribociclib Contraindicated
- Ibutilide + Ribociclib Contraindicated
Frequently asked questions
Can I take Clarithromycin with Ribociclib?
MediHelp rates the interaction as major. Clarithromycin and Ribociclib 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 raises ribociclib exposure and both drugs prolong the QT interval, so the risk of torsades de pointes is considerably increased. Ribociclib may also raise clarithromycin levels.
How serious is the interaction between Clarithromycin and Ribociclib?
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 ribociclib to 400 mg daily 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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