Drug interactions
Clarithromycin + Sufentanil
Severity: Major
Clarithromycin and Sufentanil: major interaction.
Last updated Sources: Health Canada product monograph
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
Sufentanil is cleared mainly by CYP3A4, so clarithromycin can raise its concentrations and prolong its effects. This increases the risk of serious or delayed respiratory depression and sedation.
What this interaction means in plain words
Clarithromycin and Sufentanil 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; Sufentanil belongs to Musculoskeletal.
Why it happens
Clarithromycin inhibits CYP3A4 metabolism of sufentanil.
What to do
Monitor respiration and sedation closely and reduce the sufentanil dose as needed. Extend the monitoring period after dosing.
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 Sufentanil
- Alprazolam + Sufentanil Major
- Amitriptyline + Sufentanil Major
- Amobarbital + Sufentanil Major
- Aripiprazole + Sufentanil Major
- Asenapine + Sufentanil Major
- Baclofen + Sufentanil Major
Frequently asked questions
Can I take Clarithromycin with Sufentanil?
MediHelp rates the interaction as major. Clarithromycin and Sufentanil 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. Sufentanil is cleared mainly by CYP3A4, so clarithromycin can raise its concentrations and prolong its effects. This increases the risk of serious or delayed respiratory depression and sedation.
How serious is the interaction between Clarithromycin and Sufentanil?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor respiration and sedation closely and reduce the sufentanil dose as needed. Extend the monitoring period after dosing.
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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