Drug interactions
Clarithromycin + Ticagrelor
Severity: Major
Clarithromycin and Ticagrelor: major interaction.
Last updated Sources: US FDA label
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 substantially increases ticagrelor exposure, raising the risk of bleeding and dyspnea. Ticagrelor labeling advises against use with strong CYP3A inhibitors.
What this interaction means in plain words
Clarithromycin and Ticagrelor 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; Ticagrelor belongs to Cardiovascular.
Why it happens
Strong inhibition of CYP3A4 (and P-glycoprotein) reduces ticagrelor clearance.
What to do
Avoid the combination and choose azithromycin or another antibiotic. If unavoidable, monitor closely for bleeding.
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 Ticagrelor
- Itraconazole + Ticagrelor Contraindicated
- Ketoconazole + Ticagrelor Contraindicated
- Levoketoconazole + Ticagrelor Contraindicated
- Abciximab + Ticagrelor Major
- Abrocitinib + Ticagrelor Major
- Acalabrutinib + Ticagrelor Major
Frequently asked questions
Can I take Clarithromycin with Ticagrelor?
MediHelp rates the interaction as major. Clarithromycin and Ticagrelor 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 substantially increases ticagrelor exposure, raising the risk of bleeding and dyspnea. Ticagrelor labeling advises against use with strong CYP3A inhibitors.
How serious is the interaction between Clarithromycin and Ticagrelor?
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 and choose azithromycin or another antibiotic. If unavoidable, monitor closely for bleeding.
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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