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Drug Interactions between clarithromycin and Tacrus

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

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Interactions between your drugs

Moderate

clarithromycin tacrolimus topical

Applies to: clarithromycin and Tacrus (tacrolimus topical)

MONITOR: Theoretically, coadministration with CYP450 3A4 inhibitors may increase the plasma concentrations of topical tacrolimus. The proposed mechanism involves inhibition of CYP450 3A4-mediated metabolism of tacrolimus, which is primary metabolized by this isoenzyme. However, systemic exposure from topical tacrolimus is reported to be minimal (less than 1 ng/mL) and so clinically significant drug interactions are not expected. Nevertheless, the possibility of an interaction cannot be ruled out.

MANAGEMENT: According to the manufacturer, caution is advised if topical tacrolimus is prescribed with CYP450 3A4 inhibitors. Patients should be monitored for systemic tacrolimus adverse effects including immunosuppression, infection, hyperkalemia, malignancy, nephrotoxicity, neurotoxicity, and hypertension.

References (3)
  1. (2024) "Product Information. Tacrolimus Topical (tacrolimus topical)." Accord-UK Ltd
  2. (2023) "Product Information. Protopic (tacrolimus topical)." Leo Pharma Inc
  3. (2023) "Product Information. Azematop (TACrolimus topical)." Accord Healthcare Pty Ltd

Drug and food/lifestyle interactions

Minor

clarithromycin food/lifestyle

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 (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.

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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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