Drug interactions
Clarithromycin + Venetoclax
Severity: Contraindicated
Clarithromycin and Venetoclax: contraindicated 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 increases venetoclax exposure through CYP3A4 and P-glycoprotein inhibition. During initiation and dose ramp-up this increases the risk of tumor lysis syndrome and neutropenia. After ramp-up, strong inhibitors require a major venetoclax dose reduction.
What this interaction means in plain words
Clarithromycin and Venetoclax are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Clarithromycin belongs to Anti Bacterial; Venetoclax belongs to Miscellaneous.
Why it happens
Inhibition of CYP3A4 and P-glycoprotein reduces venetoclax clearance and increases absorption.
What to do
Do not use during venetoclax initiation or ramp-up; use an alternative antibiotic. After ramp-up, if unavoidable, reduce the venetoclax dose by at least 75% and monitor for toxicity and blood counts.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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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 Venetoclax
- Itraconazole + Venetoclax Contraindicated
- Ketoconazole + Venetoclax Contraindicated
- Posaconazole + Venetoclax Contraindicated
- Venetoclax + Voriconazole Contraindicated
- Amiodarone + Venetoclax Major
- Apalutamide + Venetoclax Major
Frequently asked questions
Can I take Clarithromycin with Venetoclax?
MediHelp rates the interaction as contraindicated. Clarithromycin and Venetoclax are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Clarithromycin increases venetoclax exposure through CYP3A4 and P-glycoprotein inhibition. During initiation and dose ramp-up this increases the risk of tumor lysis syndrome and neutropenia. After ramp-up, strong inhibitors require a major venetoclax dose reduction.
How serious is the interaction between Clarithromycin and Venetoclax?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not use during venetoclax initiation or ramp-up; use an alternative antibiotic. After ramp-up, if unavoidable, reduce the venetoclax dose by at least 75% and monitor for toxicity and blood counts.
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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