Clarithromycin Oral Suspension and Viramune O/S
Determining the interaction of Clarithromycin Oral Suspension and Viramune O/S and the possibility of their joint administration.
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:Ask your doctor before using clarithromycin together with nevirapine. Using these medications together may cause clarithromycin to be less effective. Contact your doctor immediately if your infection worsens. Alternative antibiotic therapy should be considered. 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.
Professional:GENERALLY AVOID: Coadministration with nevirapine may significantly decrease the plasma concentrations of clarithromycin. The mechanism is nevirapine induction of CYP450 3A4, the isoenzyme responsible for the metabolic clearance of clarithromycin. In 15 HIV-positive subjects, nevirapine (200 mg once daily for 2 weeks followed by 200 mg twice daily for 2 weeks) decreased the peak plasma concentration (Cmax), area under the concentration-time curve (AUC) and trough plasma concentration (Cmin) of clarithromycin (500 mg twice a day) by 23%, 31% and 57%, respectively, compared to administration of clarithromycin alone. In contrast, the Cmax and AUC of its 14-hydroxy metabolite increased by 47% and 42%, respectively, while the Cmin remained unchanged. Although 14-hydroxy-clarithromycin is pharmacologically active, it has reduced activity against Mycobacterium avium-intracellulare complex, thus overall activity against this pathogen may be compromised.
MANAGEMENT: Clarithromycin should preferably not be used in the treatment and prophylaxis of Mycobacterium avium-intracellulare complex in patients treated with nevirapine. Alternatives such as azithromycin should be considered.
- Back D, Gibbons S, Khoo S "Pharmacokinetic drug interactions with nevirapine." J Acquir Immune Defic Syndr 34 Suppl 1 (2003): S8-14
- "Product Information. Viramune (nevirapine)." Boehringer-Ingelheim, Ridgefield, CT.
Generic Name: clarithromycin
Brand name: Biaxin, Biaxin XL
Synonyms: Clarithromycin
Generic Name: nevirapine
Brand name: Viramune, Viramune XR
Synonyms: Nevirapine
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.
- Clarithromycin Oral Suspension-Viramune Suspension
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- Clarithromycin Oral Suspension-Virasal Topical
- Clarithromycin Oral Suspension-Viravan P
- Clarithromycin Oral Suspension-Viravan PDM
- Viramune O/S-Clarithromycin Suspension
- Viramune O/S-Clarithromycin Tablets
- Viramune O/S-Claritin
- Viramune O/S-Claritin Liqui-Gels
- Viramune O/S-Claritin Reditab
- Viramune O/S-Claritin Reditabs