Drug interactions
Clarithromycin + Topotecan
Severity: Moderate
Clarithromycin and Topotecan: 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 may increase topotecan absorption and systemic exposure, especially oral topotecan, potentially worsening myelosuppression and gastrointestinal toxicity.
What this interaction means in plain words
Clarithromycin and Topotecan 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; Topotecan belongs to Oncology.
Why it happens
Inhibition of P-glycoprotein and possibly BCRP increases topotecan bioavailability and reduces its clearance.
What to do
Avoid with oral topotecan and prefer a non-inhibiting antibiotic. With IV topotecan, monitor blood counts closely.
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 Topotecan
- Adenovirus types 4 and 7 live + Topotecan Contraindicated
- Amiodarone + Topotecan Major
- Cisplatin + Topotecan Major
- Cobicistat + Topotecan Major
- Cyclosporin + Topotecan Major
- Darunavir + Topotecan Major
Frequently asked questions
Can I take Clarithromycin with Topotecan?
MediHelp rates the interaction as moderate. Clarithromycin and Topotecan 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 may increase topotecan absorption and systemic exposure, especially oral topotecan, potentially worsening myelosuppression and gastrointestinal toxicity.
How serious is the interaction between Clarithromycin and Topotecan?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid with oral topotecan and prefer a non-inhibiting antibiotic. With IV topotecan, monitor blood counts closely.
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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