Drug interactions
Clarithromycin + Riociguat
Severity: Moderate
Clarithromycin and Riociguat: 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
Riociguat is cleared partly by CYP3A4, so clarithromycin can raise exposure. This may cause symptomatic hypotension.
What this interaction means in plain words
Clarithromycin and Riociguat 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; Riociguat belongs to Cardiovascular.
Why it happens
Clarithromycin inhibits CYP3A4 metabolism of riociguat.
What to do
Monitor blood pressure and consider a lower riociguat starting dose when beginning clarithromycin.
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 Riociguat
- Avanafil + Riociguat Contraindicated
- Dipyridamole + Riociguat Contraindicated
- Isosorbide dinitrate + Riociguat Contraindicated
- Isosorbide mononitrate + Riociguat Contraindicated
- Nitroglycerin + Riociguat Contraindicated
- Riociguat + Sildenafil Contraindicated
Frequently asked questions
Can I take Clarithromycin with Riociguat?
MediHelp rates the interaction as moderate. Clarithromycin and Riociguat 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. Riociguat is cleared partly by CYP3A4, so clarithromycin can raise exposure. This may cause symptomatic hypotension.
How serious is the interaction between Clarithromycin and Riociguat?
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 blood pressure and consider a lower riociguat starting dose when beginning clarithromycin.
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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