Interactions médicamenteuses
Clarithromycin + Ivacaftor
Gravité: Majeure
Clarithromycin and Ivacaftor: major interaction.
Dernière mise à jour Sources: US FDA label
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Résumé
Clarithromycin increases ivacaftor exposure and may increase ivacaftor-related adverse effects such as elevated transaminases, headache, and dizziness. The effect is that of a strong CYP3A inhibitor and requires a dose reduction of ivacaftor.
Ce que signifie cette interaction, en termes simples
Clarithromycin and Ivacaftor 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; Ivacaftor belongs to Miscellaneous.
Pourquoi elle survient
Clarithromycin is a strong CYP3A4 inhibitor that reduces the metabolism of ivacaftor, a sensitive CYP3A substrate.
Conduite à tenir
Reduce ivacaftor to the labeled dose for use with strong CYP3A inhibitors (a reduced frequency, such as once or twice weekly depending on the formulation and age). Consider azithromycin as an alternative macrolide with minimal CYP3A inhibition.
Questions à poser à votre pharmacien
- 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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Références
Autres interactions de Ivacaftor
- Ensitrelvir + Ivacaftor Contre-indiquée
- Apalutamide + Ivacaftor Majeure
- Carbamazepine + Ivacaftor Majeure
- Efavirenz + Ivacaftor Majeure
- Enzalutamide + Ivacaftor Majeure
- Ivacaftor + Oxcarbazepine Majeure
Autres interactions de Clarithromycin
- Astemizole + Clarithromycin Contre-indiquée
- Avanafil + Clarithromycin Contre-indiquée
- Cisapride + Clarithromycin Contre-indiquée
- Clarithromycin + Colchicine Contre-indiquée
- Clarithromycin + Conivaptan Contre-indiquée
- Clarithromycin + Dihydroergotamine Contre-indiquée
Questions fréquentes
Can I take Clarithromycin with Ivacaftor?
MediHelp rates the interaction as major. Clarithromycin and Ivacaftor 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 increases ivacaftor exposure and may increase ivacaftor-related adverse effects such as elevated transaminases, headache, and dizziness. The effect is that of a strong CYP3A inhibitor and requires a dose reduction of ivacaftor.
How serious is the interaction between Clarithromycin and Ivacaftor?
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 ivacaftor to the labeled dose for use with strong CYP3A inhibitors (a reduced frequency, such as once or twice weekly depending on the formulation and age). Consider azithromycin as an alternative macrolide with minimal CYP3A inhibition.
What other medicines interact with Ivacaftor?
MediHelp also lists interactions of Ivacaftor with, for example, Ensitrelvir, Apalutamide, Carbamazepine. The full list is on the Ivacaftor page.
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