Drug interactions
Clarithromycin + Tiotropium-olodaterol
Severity: Moderate
Clarithromycin and Tiotropium-olodaterol: moderate 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 prolongs the QT interval and may add to the cardiac effects of olodaterol, including tachycardia and hypokalemia. Clarithromycin also inhibits CYP3A4 and P-gp, which may modestly raise olodaterol exposure.
What this interaction means in plain words
Clarithromycin and Tiotropium-olodaterol can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Clarithromycin belongs to Anti Bacterial; Tiotropium-olodaterol belongs to Respiratory.
Why it happens
Additive QT prolongation and beta2 stimulation, with possible CYP3A4/P-gp inhibition increasing olodaterol levels.
What to do
Monitor heart rate, symptoms of arrhythmia and potassium, and obtain an ECG in high-risk patients. Consider a non-macrolide antibiotic if QT risk is substantial.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Tiotropium-olodaterol
Other interactions of Clarithromycin
- Astemizole + Clarithromycin Contraindicated
- Avanafil + Clarithromycin Contraindicated
- Cisapride + Clarithromycin Contraindicated
- Clarithromycin + Colchicine Contraindicated
- Clarithromycin + Conivaptan Contraindicated
- Clarithromycin + Dihydroergotamine Contraindicated
Frequently asked questions
Can I take Clarithromycin with Tiotropium-olodaterol?
MediHelp rates the interaction as moderate. Clarithromycin and Tiotropium-olodaterol can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Clarithromycin prolongs the QT interval and may add to the cardiac effects of olodaterol, including tachycardia and hypokalemia. Clarithromycin also inhibits CYP3A4 and P-gp, which may modestly raise olodaterol exposure.
How serious is the interaction between Clarithromycin and Tiotropium-olodaterol?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor heart rate, symptoms of arrhythmia and potassium, and obtain an ECG in high-risk patients. Consider a non-macrolide antibiotic if QT risk is substantial.
What other medicines interact with Tiotropium-olodaterol?
MediHelp also lists interactions of Tiotropium-olodaterol with, for example, Amisulpride, Arformoterol, Arsenic trioxide. The full list is on the Tiotropium-olodaterol page.
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