Drug interactions
Clarithromycin + Zuranolone
Severity: Major
Clarithromycin and Zuranolone: major interaction.
Last updated Sources: EMA SmPC
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 raises zuranolone exposure by inhibiting CYP3A4. Higher levels increase the risk of excessive sedation, somnolence and impaired driving.
What this interaction means in plain words
Clarithromycin and Zuranolone 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; Zuranolone belongs to Central Nervous System.
Why it happens
Inhibition of CYP3A4-mediated metabolism of zuranolone.
What to do
Reduce the zuranolone dose as in its labeling when a strong CYP3A4 inhibitor is used. Monitor for sedation and advise against driving.
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
Other interactions of Zuranolone
- Alprazolam + Zuranolone Major
- Amobarbital + Zuranolone Major
- Apalutamide + Zuranolone Major
- Asenapine + Zuranolone Major
- Brexpiprazole + Zuranolone Major
- Butorphanol + Zuranolone Major
Frequently asked questions
Can I take Clarithromycin with Zuranolone?
MediHelp rates the interaction as major. Clarithromycin and Zuranolone 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 raises zuranolone exposure by inhibiting CYP3A4. Higher levels increase the risk of excessive sedation, somnolence and impaired driving.
How serious is the interaction between Clarithromycin and Zuranolone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reduce the zuranolone dose as in its labeling when a strong CYP3A4 inhibitor is used. Monitor for sedation and advise against driving.
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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