Drug Interactions between clarithromycin and osimertinib
This report displays the potential drug interactions for the following 2 drugs:
- clarithromycin
- osimertinib
Interactions between your drugs
clarithromycin osimertinib
Applies to: clarithromycin and osimertinib
GENERALLY AVOID: Coadministration with potent inhibitors of CYP450 3A4 may increase the plasma concentrations of osimertinib, which has been shown in vitro to be primarily metabolized by the isoenzyme. However, no pharmacokinetic data are available from drug interaction studies. Because osimertinib is associated with concentration-dependent prolongation of the QT interval, increased levels may potentiate the risk of ventricular arrhythmias such as torsade de pointes and sudden death.
MANAGEMENT: Concomitant use of osimertinib with potent CYP450 3A4 inhibitors should generally be avoided. If coadministration is required, close monitoring for adverse effects such as diarrhea, QT prolongation, torsade de pointes arrhythmia, and cardiomyopathy (e.g., cardiac failure, pulmonary edema, ejection fraction decreases) is recommended, and the osimertinib dosage adjusted accordingly or treatment discontinued as necessary.
References
- (2015) "Product Information. Tagrisso (osimertinib)." Astra-Zeneca Pharmaceuticals
Drug and food interactions
clarithromycin food
Applies to: 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
- 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
Drug Interaction Classification
Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
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. | |
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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