Drug interactions between diltiazem and clarithromycin

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  • Evidence: Anecdotal
  • 14
  • Drug interaction information
  • The half-life of azithromycin is long, around 68 hours
  • Major: Highly clinically significant
  • Avoid combinations; the risk of the interaction outweighs the benefit
  • This was a population-based cohort study
  • Severity: Severe
  • Of the total drug interactions, 113 are major, 520 are
  • Pharmacodynamics
  • Severe interactions are highlighted with a red marker
  • Major: Highly clinically significant
  • This is not a complete list of side effects and others may occur
  • Conclusions and relevance: Among older adults taking a calcium-channel blocker, concurrent use of clarithromycin compared with azithromycin was associated with a small but statistically significant greater 30-day risk of hospitalization with acute kidney injury

    All generic drug interactions for clarithromycin oral (lists will include brand and generic names): 19 contraindicated drug interactions; NSAIDs (nonsteroidal anti-inflammatory drugs) are pain relievers like ibuprofen or naproxen

    Bottom line References PeopleImages/iStock via Getty Images Plus Diltiazem (Cardizem) is a popular medication used to manage high blood pressure and relieve angina (chest pain)

    Clarithromycin is a macrolide antibiotic whose spectrum of activity includes many gram-positive (Staphylococcus aureus, S

    The interaction between colchicine and clarithromycin occurs not only by concomitant use of multiple doses, but also single doses

    The concomitant use of calcium-channel blockers and macrolide antibiotics increases the levels of calcium-channel blockers in the blood as they are metabolised by cytochrome P450 3A4 (CYP3A4), which is inhibited by macrolide antibiotics

    The most commonly reported interacting drugs were amiodarone and ritonavir (bleeding), and phenobarbital, phenytoin, and carbamazepine (thrombosis)

    We have described a potential interaction between clarithromycin and rivaroxaban

    Of the total drug interactions, 6 are major, 226 are moderate, and 3 are minor

    The relevance of a particular drug interaction to a specific individual is difficult to determine

    1%) and discharge (24

    43, 44 For the CYP3A and Drug interactions between antiplatelet or novel oral anticoagulant medications and Drug-Drug Interactions Between Ritonavir-Boosted Nirmatrelvir (Paxlovid) and Concomitant Medications

    Drug interaction information

    The relevance of a particular drug interaction to a specific individual is difficult to determine

    pylori treatment combined erythromycin and clarithromycin (1 retrospective cohort 15); single dose of dabigatran 300 mg and 500 mg clarithromycin twice daily ↑ AUC by 49% and C max by 60% (clinical trial in 10 healthy Abstract

    A 64-year-old African-American man was admitted to the hospital for worsening renal Risk of QT prolongation through drug interactions between hydroxychloroquine and concomitant drugs prescribed in real world practice

    Major: Highly clinically significant

    This is not a complete list of side effects and others may occur

    Applies to: clarithromycin and Xanax (alprazolam) Using ALPRAZolam and clarithromycin is not recommended

    Polypharmacy is becoming a significant issue due to the increasing prevalence of multi-morbidity and the growing population

    These classifications are only a guideline

    Moderate Diltiazem and verapamil are both moderate-weak inhibitors of CYP3A4 and substrates for P-gp

    Carbamazepine, phenytoin, phenobarbital and primidone induce many cytochrome P450 (CYP) and glucuronyl transferase (GT However, elderly patients are more likely to have age-related kidney, liver, or heart problems, which may require caution and an adjustment in the dose for patients receiving diltiazem

    Pharmacodynamic: Occurring between drugs that have similar or opposite pharmacologic effects or adverse effects; for example, these effects may occur because of competition at receptor sites or action of the drugs on the same physiologic system

    It is not practi- cal to try to memorize the many CYP3A4 substrates, but it would be prudent to be familiar with the most common CYP3A4 inhibitors and inducers since such drugs are likely to interact with approximately half of all drugs on the market

    When combined with digoxin, they can cause new or worsening heart rhythm problems

    6

    Cytochrome P450 3A4 (CYP3A4) is the major enzyme responsible for the most statin medication metabolism 14-16

    Moderate See more Coadministration of clarithromycin and drugs primarily metabolized by CYP3A, such as diltiazem, may result in increased substrate exposure and prolonged therapeutic and

    Possible drug interactions with clarithromycin include: Calcium channel blockers (CCBs) — there is

    Clarithromycin has the following interaction information: Drug interaction information Severe interactions are highlighted with a red marker

    Clarithromycin, erythromycin: Statins: simvastatin, atorvastatin, fluvastatin: Diltiazem, verapamil: Cancer drugs: 21, 66 for example, kinase inhibitors cobimetinib

    Blood concentrations of these drugs may rise to

    At 33 hours after this patient’s last dose of rivaroxaban, his anti-factor Xa

    Images

    Aceclofenac is predicted to increase the risk of toxicity when given with Methotrexate (particularly high-dose)

    There are 235 drugs known to interact with levetiracetam, along with 4 disease interactions, and 1 alcohol/food interaction

    Includes information on severity of interaction and the level of evidence for it

    Manufacturer makes no recommendation Diltiazem: Amlodipine, Diltiazem: [See WARNINGS AND PRECAUTIONS] There have been postmarketing reports of drug interactions when clarithromycin is co-administered with cisapride or pimozide, resulting in cardiac arrhythmias (QT prolongation, ventricular tachycardia, ventricular fibrillation, and torsades de pointes) most likely due to The potential interaction is well documented and The World Health Organization Adverse Drug Reaction database found a definitive association in increased risk with azithromycin and atorvastatin

    The most well-studied of these involves the

    Overall, more coprescriptions were generated, than were eliminated by hospital physicians

    These classifications are only a guideline

    Moderate Drug Interactions between Antimicrobials and Immunosuppressants

    Severe interactions are highlighted with a red marker

    Always consult your healthcare provider before starting or stopping any medication

    Abstract

    A 64-year-old African-American man was admitted to the hospital for worsening renal Introduction

    At 33 hours after this patient’s last dose of rivaroxaban, his anti-factor Xa level was 537 μg/L, consistent with a marked increase in exposure, despite preservation of renal and hepatic function and a low baseline risk of bleeding

    Major: Highly clinically significant

    Always consult your healthcare provider before starting or stopping any medication

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