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Interactions médicamenteuses

Astemizole + Clarithromycin

Gravité: Contre-indiquée

Astemizole and Clarithromycin: contraindicated interaction.

Dernière mise à jour Sources: US FDA label

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Résumé

Clarithromycin raises astemizole concentrations and, together with the intrinsic QT effect of both drugs, may cause torsades de pointes and sudden death. The combination is contraindicated. Astemizole has been withdrawn in many markets, so the interaction is mainly of historical relevance.

Ce que signifie cette interaction, en termes simples

Astemizole and Clarithromycin are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.

Niveau de preuve: High

Pourquoi elle survient

Clarithromycin inhibits CYP3A4-mediated metabolism of astemizole and also prolongs QT through IKr blockade, giving pharmacokinetic and pharmacodynamic synergy.

Conduite à tenir

Do not combine. Use a non-sedating antihistamine without QT liability, such as fexofenadine, loratadine or cetirizine.

Questions à poser à votre pharmacien

  • Is there an alternative to one of these two medicines for me?
  • If both are essential, who is monitoring me and how often?
  • Which symptoms mean I should stop and seek help straight away?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Références

Questions fréquentes

Can I take Astemizole with Clarithromycin?

MediHelp rates the interaction as contraindicated. Astemizole and Clarithromycin are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Clarithromycin raises astemizole concentrations and, together with the intrinsic QT effect of both drugs, may cause torsades de pointes and sudden death. The combination is contraindicated. Astemizole has been withdrawn in many markets, so the interaction is mainly of historical relevance.

How serious is the interaction between Astemizole and Clarithromycin?

MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not combine. Use a non-sedating antihistamine without QT liability, such as fexofenadine, loratadine or cetirizine.

What other medicines interact with Clarithromycin?

MediHelp also lists interactions of Clarithromycin with, for example, Avanafil, Cisapride, Colchicine. The full list is on the Clarithromycin page.

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