Drug interactions
Clarithromycin + Rilpivirine
Severity: Major
Clarithromycin and Rilpivirine: 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 rilpivirine exposure through CYP3A4 inhibition, and both drugs can prolong the QT interval. The combination increases the risk of QT prolongation and arrhythmia.
What this interaction means in plain words
Clarithromycin and Rilpivirine 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; Rilpivirine belongs to Anti Virals.
Why it happens
CYP3A4 inhibition increases rilpivirine levels, with additive QT-prolonging effects.
What to do
Use an alternative such as azithromycin where feasible. If combined, obtain an ECG and correct potassium and magnesium.
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 Rilpivirine
- Carbamazepine + Rilpivirine Contraindicated
- Dexamethasone + Rilpivirine Contraindicated
- Dexlansoprazole + Rilpivirine Contraindicated
- Efavirenz + Rilpivirine Contraindicated
- Eslicarbazepine + Rilpivirine Contraindicated
- Esomeprazole + Rilpivirine Contraindicated
Frequently asked questions
Can I take Clarithromycin with Rilpivirine?
MediHelp rates the interaction as major. Clarithromycin and Rilpivirine 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 rilpivirine exposure through CYP3A4 inhibition, and both drugs can prolong the QT interval. The combination increases the risk of QT prolongation and arrhythmia.
How serious is the interaction between Clarithromycin and Rilpivirine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use an alternative such as azithromycin where feasible. If combined, obtain an ECG and correct potassium and magnesium.
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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