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Biaxin (Clarithromycin Oral Suspension) and Kaletra

Determining the interaction of Biaxin (Clarithromycin Oral Suspension) and Kaletra and the possibility of their joint administration.

Check result:

Biaxin (Clarithromycin Oral Suspension) <> Kaletra

Relevance: 16.05.2023 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

Using clarithromycin together with ritonavir may increase the effects of clarithromycin. Contact your doctor if you experience nausea, vomiting, diarrhea, and abdominal discomfort. If your doctor does prescribe these medications together, you may need a dose adjustment or special test to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Professional:

ADJUST DOSE: Coadministration with ritonavir may increase the plasma concentrations of clarithromycin. The mechanism is ritonavir inhibition of CYP450 3A4, the isoenzyme responsible for the metabolic conversion of clarithromycin to 14-hydroxyclarithromycin. In 22 healthy volunteers, administration of clarithromycin (500 mg every 12 hours) with ritonavir (200 mg every 8 hours) for 4 days increased the mean peak plasma concentration (Cmax), area under the concentration-time curve (AUC) and trough plasma concentration (Cmin) of clarithromycin by 31%, 77% and 180%, respectively, compared to administration without ritonavir. The formation of 14-hydroxyclarithromycin was nearly completely inhibited, as indicated by a 100% decrease in Cmax, AUC, and Cmin in the presence of ritonavir. In contrast, clarithromycin had only minor effects on the pharmacokinetics of ritonavir.

MANAGEMENT: No dosage adjustment of clarithromycin or ritonavir is required during coadministration in patients with normal renal function. However, clarithromycin dosage should be reduced by 50% in patients with moderate renal impairment (CrCl 30 to 60 mL/min) and 75% in patients with more severe renal impairment (CrCl below 30 mL/min).

References

Ouellet D, Hsu A, Granneman GR, et al. "Assessment of the pharmacokinetic interaction between ritonavir and clarithromycin." Clin Pharmacol Ther 59 (1996): 143
Ouellet D, Hsu A, Granneman GR, Carlson G, Cavanaugh J, Guenther H, Leonard JM "Pharmacokinetic interaction between ritonavir and clarithromycin." Clin Pharmacol Ther 64 (1998): 355-62
"Product Information. Norvir (ritonavir)." Abbott Pharmaceutical, Abbott Park, IL.

Biaxin (Clarithromycin Oral Suspension)

Generic Name: clarithromycin

Brand name: Biaxin, Biaxin XL

Synonyms: Biaxin (Oral Suspension), Biaxin

What is Biaxin (Clarithromycin Oral Suspension)?

Kaletra

Generic Name: lopinavir / ritonavir

Brand name: Kaletra

Synonyms: n.a.

What is Kaletra?

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In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

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