Interazioni tra farmaci
Clarithromycin + Tolterodine
Gravità: Maggiore
Clarithromycin and Tolterodine: major interaction.
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Sintesi
Clarithromycin is a strong CYP3A4 inhibitor and raises tolterodine exposure, particularly in CYP2D6 poor metabolizers. Increased levels may enhance anticholinergic effects and QT prolongation risk, and both drugs have QT liability.
Cosa significa questa interazione in parole semplici
Clarithromycin and Tolterodine 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; Tolterodine belongs to Genitourinary.
Perché avviene
Strong CYP3A4 inhibition by clarithromycin reduces tolterodine metabolism, with additive QT effects.
Cosa fare
Limit tolterodine to 2 mg daily (1 mg twice daily for IR) during co-treatment, or use an alternative antibiotic such as azithromycin; monitor ECG in patients with QT risk factors.
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?
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Altre interazioni di Tolterodine
- Clozapine + Tolterodine Maggiore
- Cobicistat + Tolterodine Maggiore
- Dronedarone + Tolterodine Maggiore
- Droperidol + Tolterodine Maggiore
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Tolterodine Maggiore
- Erythromycin base + Tolterodine Maggiore
Altre interazioni di Clarithromycin
- Astemizole + Clarithromycin Controindicata
- Avanafil + Clarithromycin Controindicata
- Cisapride + Clarithromycin Controindicata
- Clarithromycin + Colchicine Controindicata
- Clarithromycin + Conivaptan Controindicata
- Clarithromycin + Dihydroergotamine Controindicata
Domande frequenti
Can I take Clarithromycin with Tolterodine?
MediHelp rates the interaction as major. Clarithromycin and Tolterodine 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 raises tolterodine exposure, particularly in CYP2D6 poor metabolizers. Increased levels may enhance anticholinergic effects and QT prolongation risk, and both drugs have QT liability.
How serious is the interaction between Clarithromycin and Tolterodine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Limit tolterodine to 2 mg daily (1 mg twice daily for IR) during co-treatment, or use an alternative antibiotic such as azithromycin; monitor ECG in patients with QT risk factors.
What other medicines interact with Tolterodine?
MediHelp also lists interactions of Tolterodine with, for example, Clozapine, Cobicistat, Dronedarone. The full list is on the Tolterodine page.
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