Drug interactions
Clarithromycin + Verapamil
Severity: Major
Clarithromycin and Verapamil: major interaction.
Last updated Sources: US FDA label
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 can substantially raise verapamil concentrations, and verapamil can also slow clarithromycin clearance. Reported consequences include hypotension, bradycardia, AV block and acute kidney injury, particularly in older patients.
What this interaction means in plain words
Clarithromycin and Verapamil 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; Verapamil belongs to Cardiovascular.
Why it happens
Inhibition of CYP3A4 and P-glycoprotein by both drugs, increasing exposure to verapamil.
What to do
Prefer an alternative antibiotic such as azithromycin when feasible. If combined, reduce the verapamil dose and monitor heart rate, blood pressure and renal function.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Clarithromycin and Verapamil, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
References
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 Verapamil
- Dofetilide + Verapamil Contraindicated
- Flibanserin + Verapamil Contraindicated
- Lomitapide + Verapamil Contraindicated
- Lonafarnib + Verapamil Contraindicated
- Pimozide + Verapamil Contraindicated
- Acebutolol + Verapamil Major
Frequently asked questions
Can I take Clarithromycin with Verapamil?
MediHelp rates the interaction as major. Clarithromycin and Verapamil 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 can substantially raise verapamil concentrations, and verapamil can also slow clarithromycin clearance. Reported consequences include hypotension, bradycardia, AV block and acute kidney injury, particularly in older patients.
How serious is the interaction between Clarithromycin and Verapamil?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Prefer an alternative antibiotic such as azithromycin when feasible. If combined, reduce the verapamil dose and monitor heart rate, blood pressure and renal function.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
