Drug interactions
Clarithromycin + Ritonavir
Severity: Moderate
Clarithromycin and Ritonavir: 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
Ritonavir inhibits clarithromycin metabolism and clarithromycin may modestly raise ritonavir levels. Clarithromycin accumulation is clinically relevant in renal impairment and may lead to QT prolongation.
What this interaction means in plain words
Clarithromycin and Ritonavir 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; Ritonavir belongs to Anti Virals.
Why it happens
Mutual CYP3A4 inhibition; ritonavir reduces clarithromycin clearance.
What to do
Reduce the clarithromycin dose in patients with renal impairment; no adjustment is usually needed with normal renal function, and doses above 1 g/day should be avoided. Monitor ECG in at-risk patients.
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 Ritonavir
- Alfuzosin + Ritonavir Contraindicated
- Amiodarone + Ritonavir Contraindicated
- Avanafil + Ritonavir Contraindicated
- Colchicine + Ritonavir Contraindicated
- Dronedarone + Ritonavir Contraindicated
- Eletriptan + Ritonavir Contraindicated
Frequently asked questions
Can I take Clarithromycin with Ritonavir?
MediHelp rates the interaction as moderate. Clarithromycin and Ritonavir 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. Ritonavir inhibits clarithromycin metabolism and clarithromycin may modestly raise ritonavir levels. Clarithromycin accumulation is clinically relevant in renal impairment and may lead to QT prolongation.
How serious is the interaction between Clarithromycin and Ritonavir?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reduce the clarithromycin dose in patients with renal impairment; no adjustment is usually needed with normal renal function, and doses above 1 g/day should be avoided. Monitor ECG in at-risk patients.
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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