Drug interactions
Clarithromycin + Vinblastine
Severity: Major
Clarithromycin and Vinblastine: 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 can increase vinblastine exposure, raising the risk of neurotoxicity, severe myelosuppression and constipation or ileus. Vinca alkaloids have a narrow therapeutic index, so the interaction may be serious.
What this interaction means in plain words
Clarithromycin and Vinblastine 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; Vinblastine belongs to Oncology.
Why it happens
Inhibition of CYP3A4 metabolism and P-glycoprotein efflux of vinblastine by clarithromycin.
What to do
Avoid the combination when possible and use an alternative antibiotic with little CYP3A4 effect. If unavoidable, monitor blood counts and neurologic and bowel function closely.
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 Vinblastine
Frequently asked questions
Can I take Clarithromycin with Vinblastine?
MediHelp rates the interaction as major. Clarithromycin and Vinblastine 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 increase vinblastine exposure, raising the risk of neurotoxicity, severe myelosuppression and constipation or ileus. Vinca alkaloids have a narrow therapeutic index, so the interaction may be serious.
How serious is the interaction between Clarithromycin and Vinblastine?
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 the combination when possible and use an alternative antibiotic with little CYP3A4 effect. If unavoidable, monitor blood counts and neurologic and bowel function 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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