Drug interactions
Clarithromycin + Sunitinib
Severity: Major
Clarithromycin and Sunitinib: major interaction.
Last updated Sources: UK SmPC
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 can raise sunitinib and active metabolite exposure, increasing toxicity. Both drugs also prolong the QT interval, adding arrhythmic risk.
What this interaction means in plain words
Clarithromycin and Sunitinib 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; Sunitinib belongs to Oncology.
Why it happens
CYP3A4 inhibition reduces sunitinib metabolism, plus additive QT prolongation.
What to do
Use an alternative antibiotic that does not inhibit CYP3A4. If unavoidable, consider reducing the sunitinib dose per labeling and monitor ECG and electrolytes.
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 Sunitinib
- Adagrasib + Sunitinib Major
- Amiodarone + Sunitinib Major
- Amisulpride + Sunitinib Major
- Anagrelide + Sunitinib Major
- Apalutamide + Sunitinib Major
- Arsenic trioxide + Sunitinib Major
Frequently asked questions
Can I take Clarithromycin with Sunitinib?
MediHelp rates the interaction as major. Clarithromycin and Sunitinib 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 can raise sunitinib and active metabolite exposure, increasing toxicity. Both drugs also prolong the QT interval, adding arrhythmic risk.
How serious is the interaction between Clarithromycin and Sunitinib?
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 antibiotic that does not inhibit CYP3A4. If unavoidable, consider reducing the sunitinib dose per labeling and monitor ECG and electrolytes.
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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