Drug interactions
Clarithromycin + Tolazamide
Severity: Moderate
Clarithromycin and Tolazamide: 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
Macrolides, including clarithromycin, have been associated with hypoglycemia in patients taking sulfonylureas. Tolazamide effects may be enhanced, with risk greatest in older patients and those with renal impairment.
What this interaction means in plain words
Clarithromycin and Tolazamide 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; Tolazamide belongs to Endocrine.
Why it happens
Mechanism is not firmly established and may involve altered sulfonylurea metabolism or enhanced insulin secretion.
What to do
Monitor blood glucose closely during and after the clarithromycin course. Counsel the patient on hypoglycemia symptoms and reduce the tolazamide dose if needed.
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 Clarithromycin
- Astemizole + Clarithromycin Contraindicated
- Avanafil + Clarithromycin Contraindicated
- Cisapride + Clarithromycin Contraindicated
- Clarithromycin + Colchicine Contraindicated
- Clarithromycin + Conivaptan Contraindicated
- Clarithromycin + Dihydroergotamine Contraindicated
Other interactions of Tolazamide
- Disopyramide + Tolazamide Major
- Insulin degludec-liraglutide + Tolazamide Major
- Aceclofenac + Tolazamide Moderate
- Acemetacin + Tolazamide Moderate
- Acetylsalicylic acid + Tolazamide Moderate
- Albiglutide + Tolazamide Moderate
Frequently asked questions
Can I take Clarithromycin with Tolazamide?
MediHelp rates the interaction as moderate. Clarithromycin and Tolazamide 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. Macrolides, including clarithromycin, have been associated with hypoglycemia in patients taking sulfonylureas. Tolazamide effects may be enhanced, with risk greatest in older patients and those with renal impairment.
How serious is the interaction between Clarithromycin and Tolazamide?
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 blood glucose closely during and after the clarithromycin course. Counsel the patient on hypoglycemia symptoms and reduce the tolazamide dose if needed.
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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