Drug interactions
Clarithromycin + Rifapentine
Severity: Major
Clarithromycin and Rifapentine: 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
Rifapentine is a CYP3A4 inducer that can substantially lower clarithromycin concentrations, risking loss of efficacy, for example in mycobacterial infections. Induction effects may persist after stopping rifapentine.
What this interaction means in plain words
Clarithromycin and Rifapentine 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; Rifapentine belongs to Anti Bacterial.
Why it happens
Rifapentine induces CYP3A4 and increases clarithromycin metabolism, although its induction is somewhat weaker than rifampicin.
What to do
Avoid the combination where possible or monitor clinical and microbiological response closely. Consider an alternative macrolide or agent less affected by induction.
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 Rifapentine
- Ledipasvir-sofosbuvir + Rifapentine Contraindicated
- Lorlatinib + Rifapentine Contraindicated
- Lurasidone + Rifapentine Contraindicated
- Ranolazine + Rifapentine Contraindicated
- Rifapentine + Sofosbuvir-velpatasvir Contraindicated
- Rifapentine + Sofosbuvir-velpatasvir-voxilaprevir Contraindicated
Frequently asked questions
Can I take Clarithromycin with Rifapentine?
MediHelp rates the interaction as major. Clarithromycin and Rifapentine 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. Rifapentine is a CYP3A4 inducer that can substantially lower clarithromycin concentrations, risking loss of efficacy, for example in mycobacterial infections. Induction effects may persist after stopping rifapentine.
How serious is the interaction between Clarithromycin and Rifapentine?
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 possible or monitor clinical and microbiological response closely. Consider an alternative macrolide or agent less affected by induction.
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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