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Drug Interactions between amoxicillin / clarithromycin / vonoprazan and pimecrolimus topical

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Minor

amoxicillin clarithromycin

Applies to: amoxicillin / clarithromycin / vonoprazan and amoxicillin / clarithromycin / vonoprazan

Although some in vitro data indicate synergism between macrolide antibiotics and penicillins, other in vitro data indicate antagonism. When these drugs are given together, neither has predictable therapeutic efficacy. Data are available for erythromycin, although theoretically this interaction could occur with any macrolide. Except for monitoring of the effectiveness of antibiotic therapy, no special precautions appear to be necessary.

References (3)
  1. Strom J (1961) "Penicillin and erythromycin singly and in combination in scarlatina therapy and the interference between them." Antibiot Chemother, 11, p. 694-7
  2. Cohn JR, Jungkind DL, Baker JS (1980) "In vitro antagonism by erythromycin of the bactericidal action of antimicrobial agents against common respiratory pathogens." Antimicrob Agents Chemother, 18, p. 872-6
  3. Penn RL, Ward TT, Steigbigel RT (1982) "Effects of erythromycin in combination with penicillin, ampicillin, or gentamicin on the growth of listeria monocytogenes." Antimicrob Agents Chemother, 22, p. 289-94
Minor

clarithromycin pimecrolimus topical

Applies to: amoxicillin / clarithromycin / vonoprazan and pimecrolimus topical

Theoretically, coadministration with CYP450 3A inhibitors may increase the plasma concentrations of pimecrolimus, which has been shown in vitro to undergo metabolism by this subfamily of hepatic microsomal enzymes. Although clinically significant drug interactions are not expected due to minimal systemic absorption of topically administered pimecrolimus, the possibility cannot be ruled out. The manufacturer recommends caution in patients with widespread and/or erythrodermic disease.

References (1)
  1. (2002) "Product Information. Elidel (pimecrolimus topical)." Novartis Pharmaceuticals
Minor

pimecrolimus topical vonoprazan

Applies to: pimecrolimus topical and amoxicillin / clarithromycin / vonoprazan

Theoretically, coadministration with CYP450 3A inhibitors may increase the plasma concentrations of pimecrolimus, which has been shown in vitro to undergo metabolism by this subfamily of hepatic microsomal enzymes. Although clinically significant drug interactions are not expected due to minimal systemic absorption of topically administered pimecrolimus, the possibility cannot be ruled out. The manufacturer recommends caution in patients with widespread and/or erythrodermic disease.

References (1)
  1. (2002) "Product Information. Elidel (pimecrolimus topical)." Novartis Pharmaceuticals

Drug and food interactions

Minor

clarithromycin food

Applies to: amoxicillin / clarithromycin / vonoprazan

Grapefruit juice may delay the gastrointestinal absorption of clarithromycin but does not appear to affect the overall extent of absorption or inhibit the metabolism of clarithromycin. The mechanism of interaction is unknown but may be related to competition for intestinal CYP450 3A4 and/or absorptive sites. In an open-label, randomized, crossover study consisting of 12 healthy subjects, coadministration with grapefruit juice increased the time to reach peak plasma concentration (Tmax) of both clarithromycin and 14-hydroxyclarithromycin (the active metabolite) by 80% and 104%, respectively, compared to water. Other pharmacokinetic parameters were not significantly altered. This interaction is unlikely to be of clinical significance.

References (1)
  1. Cheng KL, Nafziger AN, Peloquin CA, Amsden GW (1998) "Effect of grapefruit juice on clarithromycin pharmacokinetics." Antimicrob Agents Chemother, 42, p. 927-9

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

See also

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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