Biaxin Filmtab and Reyataz (Atazanavir Powder for Oral Suspension)

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.

Using clarithromycin together with atazanavir may alter the effects of clarithromycin. Contact your doctor if your condition worsens or if you have symptoms of irregular heartbeat, chest tightness, blurred vision or nausea. You may need a dose adjustment or special test if you 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.

ADJUST DOSE: Coadministration with atazanavir may significantly increase the plasma concentration of clarithromycin but decrease that of the active metabolite, 14-OH clarithromycin. The mechanism is atazanavir inhibition of CYP450 3A4, the isoenzyme responsible for the metabolism of clarithromycin. In 21 study subjects, atazanavir (400 mg once a day for 10 days) increased the mean steady-state peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) of clarithromycin (500 mg once a day) by 50% and 94%, respectively, compared to administration of clarithromycin alone. In contrast, the Cmax and AUC of 14-OH clarithromycin were significantly reduced by 72% and 70%, respectively.

MANAGEMENT: Because increased plasma concentrations of clarithromycin may cause prolongation of the QT interval of the electrocardiogram, a dose reduction of clarithromycin by 50% is recommended for patients with moderate renal insufficiency (CrCl 30 to 60 mL/min) and a dose reduction by 75% is recommended for patients with severe renal insufficiency (CrCl less than 30 mL/min). The daily dose of clarithromycin should not exceed 1000 mg during concomitant use with protease inhibitors. In addition, because plasma concentrations of the active metabolite is significantly reduced, alternative therapy should be considered for indications other than infections due to Mycobacterium avium complex. Some authorities recommend avoiding the use of the fixed combination atazanavir-cobicistat with clarithromycin.

Biaxin Filmtab

Generic Name: clarithromycin

Brand name: Biaxin, Biaxin XL

Synonyms: Biaxin (Oral Suspension), Biaxin

What is Biaxin Filmtab?

Reyataz (Atazanavir Powder for Oral Suspension)

Generic Name: atazanavir

Brand name: Reyataz

Synonyms: Reyataz

What is Reyataz (Atazanavir Powder for Oral Suspension)?