Drug interactions
Clarithromycin + Tofacitinib
Severity: Moderate
Clarithromycin and Tofacitinib: 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 is a strong CYP3A4 inhibitor and raises tofacitinib exposure. Higher exposure increases the risk of infection and other dose-related adverse effects.
What this interaction means in plain words
Clarithromycin and Tofacitinib 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; Tofacitinib belongs to Musculoskeletal.
Why it happens
Inhibition of CYP3A4-mediated metabolism of tofacitinib.
What to do
Reduce the tofacitinib dose as labeled for strong CYP3A4 inhibitors, for example to once daily when on twice-daily dosing. Alternatively use an antibiotic without CYP3A4 inhibition, such as azithromycin.
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 Tofacitinib
- Baricitinib + Tofacitinib Contraindicated
- Cladribine + Tofacitinib Contraindicated
- Tofacitinib + Upadacitinib Contraindicated
- Abatacept + Tofacitinib Major
- Anti-thymocyte + Tofacitinib Major
- Antithymocyte globulin equine + Tofacitinib Major
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 Tofacitinib?
MediHelp rates the interaction as moderate. Clarithromycin and Tofacitinib 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 is a strong CYP3A4 inhibitor and raises tofacitinib exposure. Higher exposure increases the risk of infection and other dose-related adverse effects.
How serious is the interaction between Clarithromycin and Tofacitinib?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reduce the tofacitinib dose as labeled for strong CYP3A4 inhibitors, for example to once daily when on twice-daily dosing. Alternatively use an antibiotic without CYP3A4 inhibition, such as azithromycin.
What other medicines interact with Tofacitinib?
MediHelp also lists interactions of Tofacitinib with, for example, Baricitinib, Cladribine, Upadacitinib. The full list is on the Tofacitinib page.
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