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Drug Interactions between Biaxin and dabigatran

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

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Interactions between your drugs

Minor

clarithromycin dabigatran

Applies to: Biaxin (clarithromycin) and dabigatran

Coadministration with clarithromycin may slightly increase the bioavailability of dabigatran following oral administration of dabigatran etexilate. The proposed mechanism is clarithromycin inhibition of the P-glycoprotein efflux transporter, of which dabigatran etexilate is a substrate. When dabigatran etexilate was coadministered with clarithromycin 500 mg twice a day in healthy volunteers, increases in dabigatran peak plasma concentration (Cmax) by about 15% and systemic exposure (AUC) by about 19% were observed without any clinical safety concern. Dabigatran had no significant effect on the pharmacokinetics of clarithromycin. No dosage adjustment for dabigatran etexilate is recommended during coadministration with clarithromycin, but caution may be advisable.

References (4)
  1. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  2. Cerner Multum, Inc. "Australian Product Information."
  3. (2008) "Product Information. Pradax (dabigatran)." Boehringer Ingelheim (Canada) Ltd
  4. (2010) "Product Information. Pradaxa (dabigatran)." Boehringer-Ingelheim

Drug and food interactions

Minor

clarithromycin food

Applies to: Biaxin (clarithromycin)

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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