Drug interactions
Clarithromycin + Vincristine liposomal
Severity: Major
Clarithromycin and Vincristine liposomal: major interaction.
Last updated Sources: Health Canada product monograph
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 inhibits CYP3A4 and P-glycoprotein, both of which contribute to vincristine clearance. Higher vincristine exposure can increase neurotoxicity, including peripheral neuropathy, constipation or ileus, and seizures.
What this interaction means in plain words
Clarithromycin and Vincristine liposomal 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.
Why it happens
Clarithromycin inhibits CYP3A4 metabolism and P-glycoprotein efflux of vincristine, raising its systemic exposure.
What to do
Prefer a non-interacting antibiotic such as azithromycin or a non-macrolide alternative during vincristine therapy. If unavoidable, monitor closely for neurotoxicity and gastrointestinal dysmotility.
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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References
Other interactions of Clarithromycin
- Astemizole + Clarithromycin Contraindicated
- Avanafil + Clarithromycin Contraindicated
- Cisapride + Clarithromycin Contraindicated
- Clarithromycin + Colchicine Contraindicated
- Clarithromycin + Conivaptan Contraindicated
- Clarithromycin + Dihydroergotamine Contraindicated
Frequently asked questions
Can I take Clarithromycin with Vincristine liposomal?
MediHelp rates the interaction as major. Clarithromycin and Vincristine liposomal 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 inhibits CYP3A4 and P-glycoprotein, both of which contribute to vincristine clearance. Higher vincristine exposure can increase neurotoxicity, including peripheral neuropathy, constipation or ileus, and seizures.
How serious is the interaction between Clarithromycin and Vincristine liposomal?
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 a non-interacting antibiotic such as azithromycin or a non-macrolide alternative during vincristine therapy. If unavoidable, monitor closely for neurotoxicity and gastrointestinal dysmotility.
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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