▶Rifampicinis predicted to decrease the exposure to
macitentan. Avoid.rStudy
▶St John’s Wortis predicted to decrease the exposure to
macitentan. Avoid.rTheoretical
Macrolides→seeTABLE 9p. 849 (QT-interval prolongation)
azithromycin.clarithromycin.erythromycin..
ROUTE-SPECIFIC INFORMATIONSince systemic absorption can
follow topical application, the possibility of interactions
should be borne in mind.▶Clarithromycinis predicted to increase the exposure to
abiraterone.rTheoretical
▶Macrolidesare predicted to increase the exposure toafatinib.
Separate administration by 12 hours.oStudy
▶Clarithromycinis predicted to markedly increase the exposure
toaldosterone antagonists(eplerenone). Avoid.rStudy
▶Erythromycinis predicted to increase the exposure to
aldosterone antagonists(eplerenone). Adjusteplerenonedose.
rStudy
▶Azithromycinis predicted to increase the exposure toaliskiren.
oTheoretical
▶Macrolides(clarithromycin, erythromycin)are predicted to
increase the exposure toaliskiren.oStudy
▶Clarithromycinincreases the exposure toalmotriptan.n
Study
▶Clarithromycinis predicted to moderately increase the
exposure toalpha blockers(alfuzosin, tamsulosin). Use with
caution or avoid.oStudy
▶Clarithromycinis predicted to increase the exposure toalpha
blockers(doxazosin).oStudy
▶Erythromycinis predicted to increase the exposure toalpha
blockers(tamsulosin).oTheoretical
▶Clarithromycinmoderately increases the exposure to
alprazolam. Avoid.oStudy
▶Erythromycinis predicted to increase the exposure to
alprazolam.rStudy
▶Azithromycinis predicted to increase the exposure to
aminophylline.oTheoretical
▶Clarithromycinis predicted to increase the exposure to
aminophylline. Adjust dose.oTheoretical
▶Aminophyllineis predicted to decrease the exposure to
erythromycin. Adjust dose.rStudy
▶Clarithromycinvery markedly increases the exposure to
antiarrhythmics(dronedarone). Avoid.rStudy→Also see
TABLE 9p. 849
▶Erythromycinis predicted to moderately increase the exposure
toantiarrhythmics(dronedarone). Avoid.rTheoretical→
Also seeTABLE 9p. 849
▶Macrolides(clarithromycin, erythromycin)are predicted to
increase the exposure toantiarrhythmics(lidocaine).o
Theoretical
▶Clarithromycinis predicted to increase the exposure to
antiarrhythmics(propafenone). Monitor and adjust dose.r
Study
▶Erythromycinis predicted to increase the exposure to
antiarrhythmics(propafenone). Monitor and adjust dose.
oStudy
▶Clarithromycinis predicted to increase the exposure to
anticholinesterases, centrally acting(galantamine). Monitor and
adjust dose.oStudy
▶Clarithromycinslightly increases the concentration of
antiepileptics(carbamazepine). Monitor concentration and
adjust dose.rStudy
▶Erythromycinmarkedly increases the concentration of
antiepileptics(carbamazepine). Monitor concentration and
adjust dose.rStudy
▶Clarithromycinis predicted to very slightly increase the
exposure toantiepileptics(perampanel).nStudy
▶Clarithromycinis predicted to increase the exposure to
antifungals, azoles(isavuconazole). Avoid or monitor side
effects.rStudy
▶Erythromycinis predicted to increase the exposure to
antifungals, azoles(isavuconazole).oTheoretical
▶Clarithromycinis predicted to increase the exposure to
antihistamines, non-sedating(mizolastine). Avoid.rStudy
▶Erythromycinis predicted to increase the exposure to
antihistamines, non-sedating(mizolastine).rTheoretical
▶Macrolides(clarithromycin, erythromycin)are predicted to
increase the exposure toantihistamines, non-sedating
(rupatadine). Avoid.oStudy
▶Macrolides(clarithromycin, erythromycin)are predicted to
increase the concentration ofantimalarials(piperaquine).
rTheoretical
▶Clarithromycinis predicted to increase the exposure to
apixaban.rTheoretical
▶Erythromycinis predicted to increase the exposure to
apixaban.oTheoretical
▶Clarithromycinis predicted to markedly increase the exposure
toaprepitant.oStudy
▶Clarithromycinis predicted to slightly increase the exposure to
aripiprazole. Adjustaripiprazoledose,p. 249.oStudy
▶Clarithromycinis predicted to increase the exposure to
axitinib. Avoid or adjust dose.oStudy
▶Erythromycinis predicted to increase the exposure toaxitinib.
oTheoretical
▶Clarithromycinis predicted to increase the exposure to
bedaquiline. Avoid prolonged use.nStudy→Also seeTABLE 9
p. 849
▶Erythromycinis predicted to increase the exposure to
bedaquiline. Avoid prolonged use.nTheoretical→Also see
TABLE 9p. 849
▶Macrolidesare predicted to increase the exposure tobeta
blockers, non-selective(nadolol).oStudy
▶Clarithromycinis predicted to increase the exposure tobeta 2
agonists(salmeterol). Avoid.rStudy
▶Clarithromycinslightly increases the exposure tobortezomib.
oStudy
▶Clarithromycinis predicted to increase the exposure to
bosentan.oTheoretical
▶Clarithromycinis predicted to markedly increase the exposure
tobosutinib. Avoid or adjust dose.rStudy→Also see
TABLE 9p. 849
▶Erythromycinis predicted to increase the exposure to
bosutinib. Avoid or adjust dose.rTheoretical→Also see
TABLE 9p. 849
▶Clarithromycinis predicted to increase the exposure to
buspirone. Adjustbuspironedose.rStudy
▶Erythromycinis predicted to increase the exposure to
buspirone. Use with caution and adjust dose.oStudy
▶Clarithromycinslightly increases the exposure tocabozantinib.
oStudy→Also seeTABLE 9p. 849
▶Erythromycinis predicted to increase the exposure to
cabozantinib.oTheoretical→Also seeTABLE 9p. 849
▶Erythromycinis predicted to increase the exposure tocalcium
channel blockers(amlodipine, felodipine, lacidipine,
lercanidipine, nicardipine, nifedipine, nimodipine). Monitor and
adjust dose.oStudy
▶Clarithromycinis predicted to increase the exposure tocalcium
channel blockers(amlodipine, felodipine, lacidipine, nicardipine,
nifedipine, nimodipine). Monitor and adjust dose.o
Study
▶Erythromycinis predicted to increase the exposure tocalcium
channel blockers(diltiazem).rTheoretical
▶Clarithromycinis predicted to increase the exposure tocalcium
channel blockers(diltiazem, verapamil).rStudy
▶Clarithromycinis predicted to markedly increase the exposure
tocalcium channel blockers(lercanidipine). Avoid.rStudy
▶Erythromycinis predicted to increase the exposure tocalcium
channel blockers(verapamil).rStudy
▶Clarithromycinis predicted to increase the exposure to
cannabis extract. Use with caution and adjust dose.o
Theoretical
▶Clarithromycinis predicted to increase the exposure to
ceritinib. Avoid or adjustceritinibdose.rStudy→Also see
TABLE 9p. 849
▶Macrolides(azithromycin, erythromycin)are predicted to
increase the exposure toceritinib.oTheoretical→Also
seeTABLE 9p. 849
▶Macrolides(clarithromycin, erythromycin)increase the
concentration ofciclosporin.rStudyBNFC 2018 – 2019 Macitentan—Macrolides 947
Interactions|Appendix 1A1