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Interazioni tra farmaci

Clarithromycin + Irinotecan

Gravità: Maggiore

Clarithromycin and Irinotecan: major interaction.

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Sintesi

Clarithromycin inhibits CYP3A4 and P-glycoprotein, which may increase exposure to irinotecan and its active metabolite SN-38 by diverting it away from inactive pathways. This may worsen neutropenia and diarrhea.

Cosa significa questa interazione in parole semplici

Clarithromycin and Irinotecan 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; Irinotecan belongs to Oncology.

Livello di evidenza: Moderate

Perché avviene

CYP3A4 and P-glycoprotein inhibition by clarithromycin alters irinotecan disposition and increases toxic exposure.

Cosa fare

Choose a non-interacting antibiotic where possible. If clarithromycin is required, monitor closely for severe diarrhea and myelosuppression and adjust irinotecan as needed.

Cosa chiedere al farmacista

  • 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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Domande frequenti

Can I take Clarithromycin with Irinotecan?

MediHelp rates the interaction as major. Clarithromycin and Irinotecan 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 inhibits CYP3A4 and P-glycoprotein, which may increase exposure to irinotecan and its active metabolite SN-38 by diverting it away from inactive pathways. This may worsen neutropenia and diarrhea.

How serious is the interaction between Clarithromycin and Irinotecan?

MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Choose a non-interacting antibiotic where possible. If clarithromycin is required, monitor closely for severe diarrhea and myelosuppression and adjust irinotecan as needed.

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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