Drug interactions
Clarithromycin + Vinorelbine
Severity: Major
Clarithromycin and Vinorelbine: 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 increase vinorelbine exposure, increasing the risk of neutropenia and neurotoxicity including constipation. Because vinorelbine is largely CYP3A4 metabolized, strong inhibitors can intensify its toxicity.
What this interaction means in plain words
Clarithromycin and Vinorelbine 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; Vinorelbine belongs to Oncology.
Why it happens
Inhibition of CYP3A4-mediated vinorelbine metabolism by clarithromycin.
What to do
Prefer an alternative antibiotic. If combined, monitor neutrophil counts and neurologic and bowel function and consider vinorelbine dose reduction.
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 Vinorelbine
Frequently asked questions
Can I take Clarithromycin with Vinorelbine?
MediHelp rates the interaction as major. Clarithromycin and Vinorelbine 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 increase vinorelbine exposure, increasing the risk of neutropenia and neurotoxicity including constipation. Because vinorelbine is largely CYP3A4 metabolized, strong inhibitors can intensify its toxicity.
How serious is the interaction between Clarithromycin and Vinorelbine?
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. If combined, monitor neutrophil counts and neurologic and bowel function and consider vinorelbine dose reduction.
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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