Drug interactions
Clarithromycin + Trabectedin
Severity: Major
Clarithromycin and Trabectedin: major 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 substantially increase trabectedin exposure, raising the risk of hepatotoxicity, myelosuppression and rhabdomyolysis.
What this interaction means in plain words
Clarithromycin and Trabectedin 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; Trabectedin belongs to Oncology.
Why it happens
Clarithromycin inhibits CYP3A4, the main enzyme metabolizing trabectedin.
What to do
Avoid strong CYP3A inhibitors during trabectedin treatment and use a non-inhibiting antibiotic such as azithromycin. If unavoidable, monitor liver enzymes, CK and blood counts closely and reduce the trabectedin dose per labeling.
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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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 Trabectedin
Frequently asked questions
Can I take Clarithromycin with Trabectedin?
MediHelp rates the interaction as major. Clarithromycin and Trabectedin 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 may substantially increase trabectedin exposure, raising the risk of hepatotoxicity, myelosuppression and rhabdomyolysis.
How serious is the interaction between Clarithromycin and Trabectedin?
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 strong CYP3A inhibitors during trabectedin treatment and use a non-inhibiting antibiotic such as azithromycin. If unavoidable, monitor liver enzymes, CK and blood counts closely and reduce the trabectedin dose per labeling.
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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