Interações medicamentosas
Clarithromycin + Ivacaftor
Gravidade: Grave
Clarithromycin and Ivacaftor: major interaction.
Última atualização Fontes: US FDA label
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Resumo
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.
O que esta interação significa em palavras 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.
Por que acontece
Clarithromycin is a strong CYP3A4 inhibitor that reduces the metabolism of ivacaftor, a sensitive CYP3A substrate.
O que fazer
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.
O que perguntar ao farmacêutico
- 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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Referências
Outras interações de Ivacaftor
- Ensitrelvir + Ivacaftor Contraindicada
- Apalutamide + Ivacaftor Grave
- Carbamazepine + Ivacaftor Grave
- Efavirenz + Ivacaftor Grave
- Enzalutamide + Ivacaftor Grave
- Ivacaftor + Oxcarbazepine Grave
Outras interações de Clarithromycin
- Astemizole + Clarithromycin Contraindicada
- Avanafil + Clarithromycin Contraindicada
- Cisapride + Clarithromycin Contraindicada
- Clarithromycin + Colchicine Contraindicada
- Clarithromycin + Conivaptan Contraindicada
- Clarithromycin + Dihydroergotamine Contraindicada
Perguntas frequentes
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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