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MediHelp Référence médicamenteuse

Interactions médicamenteuses

Clarithromycin + Rifabutin

Gravité: Majeure

Clarithromycin and Rifabutin: major interaction.

Dernière mise à jour

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Résumé

Clarithromycin is a strong CYP3A4 inhibitor, and rifabutin is cleared largely by CYP3A4; clarithromycin also blocks its metabolism. Raised rifabutin exposure can lead to rifabutin toxicity including uveitis, neutropenia and arthralgia, while rifabutin lowers clarithromycin levels.

Ce que signifie cette interaction, en termes simples

Clarithromycin and Rifabutin 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; Rifabutin belongs to Anti Bacterial.

Niveau de preuve: High

Pourquoi elle survient

CYP3A4 inhibition by clarithromycin reduces first-pass and systemic clearance of rifabutin

Conduite à tenir

Avoid if an alternative exists; otherwise reduce the rifabutin dose per labelling, monitor closely for toxicity and recheck after the inhibitor is stopped.

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?

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

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Questions fréquentes

Can I take Clarithromycin with Rifabutin?

MediHelp rates the interaction as major. Clarithromycin and Rifabutin 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 is a strong CYP3A4 inhibitor, and rifabutin is cleared largely by CYP3A4; clarithromycin also blocks its metabolism. Raised rifabutin exposure can lead to rifabutin toxicity including uveitis, neutropenia and arthralgia, while rifabutin lowers clarithromycin levels.

How serious is the interaction between Clarithromycin and Rifabutin?

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 if an alternative exists; otherwise reduce the rifabutin dose per labelling, monitor closely for toxicity and recheck after the inhibitor is stopped.

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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Ouvrez le référentiel complet, vérifiez les interactions entre plusieurs médicaments et utilisez les outils de posologie dans l'application MediHelp.

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