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Drug interactions

Clarithromycin + Selumetinib

Severity: Major

Clarithromycin and Selumetinib: major 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

Clarithromycin may increase selumetinib exposure, which can intensify adverse effects such as gastrointestinal toxicity, rash, cardiomyopathy and ocular toxicity.

What this interaction means in plain words

Clarithromycin and Selumetinib 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; Selumetinib belongs to Oncology.

Evidence level: High

Why it happens

Clarithromycin inhibits CYP3A4, reducing selumetinib metabolism.

What to do

Prefer a non-CYP3A4-inhibiting antibiotic. If necessary, reduce the selumetinib dose as per labeling and resume the prior dose after about 3 half-lives of clarithromycin.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Clarithromycin with Selumetinib?

MediHelp rates the interaction as major. Clarithromycin and Selumetinib 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 may increase selumetinib exposure, which can intensify adverse effects such as gastrointestinal toxicity, rash, cardiomyopathy and ocular toxicity.

How serious is the interaction between Clarithromycin and Selumetinib?

MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Prefer a non-CYP3A4-inhibiting antibiotic. If necessary, reduce the selumetinib dose as per labeling and resume the prior dose after about 3 half-lives of 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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