▶Clarithromycinincreases the exposure toHIV-protease inhibitors
(saquinavir)andHIV-protease inhibitors(saquinavir)increase
the exposure toclarithromycin. Avoid.rStudy→Also see
TABLE 9p. 849
▶Erythromycinis predicted to increase the exposure toHIV-
protease inhibitors(saquinavir). Avoid.rTheoretical→Also
seeTABLE 9p. 849
▶Clarithromycinis predicted to very markedly increase the
exposure toibrutinib. Avoid potent inhibitors of CYP3A4 or
adjustibrutinibdose.rStudy
▶Erythromycinis predicted to increase the exposure to
ibrutinib. Adjustibrutinibdose with moderate inhibitors of
CYP3A4.rStudy
▶Clarithromycinis predicted to increase the exposure to
imatinib.oStudy
▶Erythromycinis predicted to increase the exposure toimatinib.
oTheoretical
▶Clarithromycinis predicted to increase the risk of toxicity
when given withirinotecan. Avoid.oStudy
▶Clarithromycinis predicted to increase the exposure to
ivabradine. Avoid.rStudy
▶Erythromycinis predicted to increase the exposure to
ivabradine. Avoid.rTheoretical
▶Clarithromycinis predicted to increase the exposure to
ivacaftor. Adjustivacaftorp. 186orlumacaftor with ivacaftor
p. 187dose with potent inhibitors of CYP3A4.rStudy
▶Erythromycinis predicted to increase the exposure to
ivacaftor. Adjustivacaftordose with moderate inhibitors of
CYP3A4,p. 186.rStudy
▶Clarithromycinis predicted to increase the exposure to
lapatinib. Avoid.oStudy→Also seeTABLE 9p. 849
▶Erythromycinis predicted to increase the exposure to
lapatinib.oStudy→Also seeTABLE 9p. 849
▶Clarithromycinincreases the exposure tolinezolid.o
Anecdotal
▶Azithromycinis predicted to increase the exposure to
lomitapide. Separate administration by 12 hours.o
Theoretical
▶Clarithromycinis predicted to markedly increase the exposure
tolomitapide. Avoid.rStudy
▶Erythromycinis predicted to increase the exposure to
lomitapide. Avoid.oTheoretical
▶Lumacaftoris predicted to decrease the exposure tomacrolides
(clarithromycin, erythromycin).oTheoretical
▶Clarithromycinis predicted to increase the exposure to
lurasidone. Avoid.rStudy
▶Erythromycinis predicted to increase the exposure to
lurasidone.oStudy
▶Clarithromycinis predicted to increase the exposure to
macitentan.oStudy
▶Clarithromycinis predicted to markedly increase the exposure
tomaraviroc. Adjust dose.rStudy
▶Clarithromycinis predicted to markedly to very markedly
increase the exposure tomidazolam. Avoid or adjust dose.
rStudy
▶Erythromycinis predicted to increase the exposure to
midazolam. Monitor side effects and adjust dose.rStudy
▶Clarithromycinis predicted to very markedly increase the
exposure tomidostaurin. Avoid or monitor for toxicity.r
Study
▶Erythromycinis predicted to increase the exposure to
midostaurin.oTheoretical
▶Clarithromycinis predicted to increase the exposure to
mirabegron. Adjustmirabegrondose in hepatic and renal
impairment.oStudy
▶Clarithromycinis predicted to increase the exposure to
mirtazapine.oStudy
▶Clarithromycinis predicted to increase the exposure to
modafinil.nTheoretical
▶Clarithromycinincreases the risk of neutropenia when given
withmonoclonal antibodies(brentuximab vedotin). Monitor and
adjust dose.rTheoretical
▶Clarithromycinis predicted to increase the exposure to
monoclonal antibodies(trastuzumab emtansine). Avoid.r
Theoretical
▶Clarithromycinis predicted to markedly increase the exposure
tonaloxegol. Avoid.rStudy
▶Erythromycinis predicted to increase the exposure to
naloxegol. Adjustnaloxegoldose and monitor side effects.
oStudy
▶Clarithromycinis predicted to increase the exposure to
netupitant.oStudy
▶Nevirapinedecreases the exposure toclarithromycin.o
Study
▶Clarithromycinis predicted to moderately increase the
exposure tonilotinib. Avoid.rStudy→Also seeTABLE 9
p. 849
▶Erythromycinis predicted to increase the exposure tonilotinib.
oTheoretical→Also seeTABLE 9p. 849
▶Macrolidesare predicted to increase the exposure to
nintedanib.oStudy
▶Clarithromycinis predicted to increase the exposure to
nitisinone. Adjust dose.oTheoretical
▶Clarithromycinis predicted to increase the exposure to
olaparib. Avoid potent inhibitors of CYP3A4 or adjustolaparib
dose.oStudy
▶Erythromycinis predicted to increase the exposure toolaparib.
Avoid moderate inhibitors of CYP3A4 or adjustolaparibdose.
oTheoretical
▶Erythromycinis predicted to increase the exposure toopioids
(alfentanil, buprenorphine, fentanyl, oxycodone). Monitor and
adjust dose.oStudy
▶Clarithromycinis predicted to increase the exposure toopioids
(alfentanil, buprenorphine, fentanyl, oxycodone, sufentanil).
Monitor and adjust dose.rStudy
▶Clarithromycinis predicted to increase the concentration of
opioids(methadone).rTheoretical→Also seeTABLE 9p. 849
▶Erythromycinis predicted to increase the exposure toopioids
(methadone, sufentanil).oTheoretical→Also seeTABLE 9
p. 849
▶Clarithromycinis predicted to increase the exposure to
oxybutynin.nStudy
▶Erythromycinis predicted to increase the exposure to
oxybutynin.nTheoretical
▶Clarithromycinis predicted to increase the exposure to
palbociclib. Avoid or adjustpalbociclibdose.rStudy
▶Clarithromycinis predicted to increase the exposure to
panobinostat. Adjustpanobinostatdose; in hepatic
impairment avoid.oStudy→Also seeTABLE 9p. 849
▶Macrolides(azithromycin, erythromycin)are predicted to
increase the exposure topanobinostat. Adjust dose.o
Theoretical→Also seeTABLE 9p. 849
▶Clarithromycinis predicted to increase the exposure to
paritaprevir(with ritonavir and ombitasvir). Avoid.r
Theoretical
▶Clarithromycinis predicted to increase the exposure to
pazopanib. Avoid or adjustpazopanibdose.oStudy→
Also seeTABLE 9p. 849
▶Erythromycinis predicted to increase the exposure to
pazopanib.oTheoretical→Also seeTABLE 9p. 849
▶Erythromycinis predicted to increase the exposure to
phosphodiesterase type-5 inhibitors(avanafil). Adjustavanafil
dose.oTheoretical
▶Clarithromycinis predicted to increase the exposure to
phosphodiesterase type-5 inhibitors(avanafil, vardenafil). Avoid.
rStudy→Also seeTABLE 9p. 849
▶Clarithromycinis predicted to increase the exposure to
phosphodiesterase type-5 inhibitors(sildenafil). Avoid potent
inhibitors of CYP3A4 or adjustsildenafildose,p. 120.r
Study→Also seeTABLE 9p. 849
▶Erythromycinis predicted to increase the exposure to
phosphodiesterase type-5 inhibitors(sildenafil). Monitor or
adjustsildenafildose with moderate inhibitors of CYP3A4,
p. 120.oStudy→Also seeTABLE 9p. 849
▶Clarithromycinis predicted to increase the exposure to
phosphodiesterase type-5 inhibitors(tadalafil). Use with caution
or avoid.rStudy
▶Erythromycinis predicted to increase the exposure to
phosphodiesterase type-5 inhibitors(tadalafil).rTheoreticalBNFC 2018 – 2019 Macrolides—Macrolides 949
Interactions|Appendix 1A1