藥物交互作用
Clarithromycin + Ivacaftor
嚴重程度: 嚴重
Clarithromycin and Ivacaftor: major interaction.
最後更新 來源: US FDA label
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摘要
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.
用白話說明這項交互作用的意義
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.
為什麼會發生
Clarithromycin is a strong CYP3A4 inhibitor that reduces the metabolism of ivacaftor, a sensitive CYP3A substrate.
處置方式
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.
可向藥師詢問的問題
- 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?
參考資料
Ivacaftor 的其他交互作用
Clarithromycin 的其他交互作用
常見問題
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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