Drug interactions
Clarithromycin + Suvorexant
Severity: Major
Clarithromycin and Suvorexant: 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 can substantially increase suvorexant levels, leading to excess next-day somnolence, impaired driving and possible CNS depression.
What this interaction means in plain words
Clarithromycin and Suvorexant 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; Suvorexant belongs to Central Nervous System.
Why it happens
Clarithromycin inhibits CYP3A4, the main route of suvorexant metabolism.
What to do
Avoid the combination per labeling and use an alternative antibiotic. If unavoidable, consider withholding suvorexant during clarithromycin treatment.
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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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 Suvorexant
Frequently asked questions
Can I take Clarithromycin with Suvorexant?
MediHelp rates the interaction as major. Clarithromycin and Suvorexant 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 substantially increase suvorexant levels, leading to excess next-day somnolence, impaired driving and possible CNS depression.
How serious is the interaction between Clarithromycin and Suvorexant?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination per labeling and use an alternative antibiotic. If unavoidable, consider withholding suvorexant during clarithromycin treatment.
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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