Drug interactions
Clarithromycin + Vorapaxar
Severity: Major
Clarithromycin and Vorapaxar: 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 vorapaxar exposure, raising the risk of bleeding including intracranial hemorrhage.
What this interaction means in plain words
Clarithromycin and Vorapaxar 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, the main route of vorapaxar elimination.
What to do
Avoid strong CYP3A inhibitors with vorapaxar and use an alternative antibiotic such as azithromycin. If a strong inhibitor is unavoidable, monitor closely for bleeding.
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
Frequently asked questions
Can I take Clarithromycin with Vorapaxar?
MediHelp rates the interaction as major. Clarithromycin and Vorapaxar 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 vorapaxar exposure, raising the risk of bleeding including intracranial hemorrhage.
How serious is the interaction between Clarithromycin and Vorapaxar?
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 strong CYP3A inhibitors with vorapaxar and use an alternative antibiotic such as azithromycin. If a strong inhibitor is unavoidable, monitor closely for bleeding.
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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