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Clarithromycin Tablets and Xanax

Determining the interaction of Clarithromycin Tablets and Xanax and the possibility of their joint administration.

Check result:

Clarithromycin Tablets <> Xanax

Relevance: 26.05.2022 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:

Clarithromycin may increase the blood levels of ALPRAZolam. This can increase the risk and/or severity of side effects including excessive drowsiness, motor impairment, amnesia, anxiety, hallucinations, and breathing difficulties (especially if you have a respiratory disorder such as asthma or obstructive sleep apnea). Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. You should avoid the use of alcohol while being treated with ALPRAZolam. Avoid driving or operating hazardous machinery until you know how the medication affects you, and do not exceed the dosage or frequency of use prescribed by your doctor. 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:

MONITOR: Macrolide antibiotics may increase and prolong the CNS effects of certain benzodiazepines. The mechanism is inhibition of CYP450 3A4 hepatic oxidation of the benzodiazepines. Midazolam, triazolam, and alprazolam have been specifically studied in this regard. Lorazepam, oxazepam, and temazepam are hepatically conjugated and are not expected to interact. Azithromycin and dirithromycin do not inhibit CYP450 isoenzymes.

MANAGEMENT: Patients receiving this combination should be monitored for excessive or prolonged sedation. Non-interacting benzodiazepines or antimicrobials may be considered as alternatives.

References

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Yeates RA, Laufen H, Zimmermann T, Schumacher T "Pharmacokinetic and pharmacodynamic interaction study between midazolam and the macrolide antibiotics, erythromycin clarithromycin, and the azalide azithromycin." Int J Clin Pharmacol Ther 35 (1997): 577-9
Wrighton SA, Ring BJ "Inhibition of human CYP3A catalyzed 1'-hydroxy midazolam formation by ketoconazole, nifedipine, erythromycin, cimetidine, and nizatidine." Pharm Res 11 (1994): 921-4
Kanamitsu S, Ito K, Green CE, Tyson CA, Shimada N, Sugiyama Y "Prediction of in vivo interaction between triazolam and erythromycin based on in vitro studies using human liver microsomes and recombinant human CYP3A4." Pharmaceut Res 17 (2000): 419-26
Ito K, Ogihara K, Kanamitsu SI, Itoh T "Prediction of the in vivo interaction between midazolam and macrolides based on in vitro studies using human liver microsomes." Drug Metab Dispos 31 (2003): 945-954
Yasui N, Otani K, Kaneko S, et al "A kinetic and dynamic study of oral alprazolam with and without erythromycin in humans: in vivo evidence for the involvement of CYP3a4 in alprazolam metabolism." Clin Pharmacol Ther 59 (1996): 514-9
Amsden GW "Macrolides versus azalides: a drug interaction update." Ann Pharmacother 29 (1995): 906-17
Zimmermann T, Yeates RA, Laufen H, Scharpf F, Leitold M, Wildfeuer A "Influence of the antibiotics erythromycin and azithromycin on the pharmacokinetics and pharmacodynamics of midazolam." Arzneimittelforschung 46 (1996): 213-7
Yeates RA, Laufen H, Zimmermann T "Interaction between midazolam and clarithromycin: comparison with azithromycin." Int J Clin Pharmacol Ther 34 (1996): 400-5
Gorski JC, Jones DR, HaehnerDaniels BD, Hamman MA, OMara EM, Hall SD "The contribution of intestinal and hepatic CYP3A to the interaction between midazolam and clarithromycin." Clin Pharmacol Ther 64 (1998): 133-43
Luurila H, Olkkola KT, Neuvonen PJ "Interaction between erythromycin and the benzodiazepines diazepam and flunitrazepam." Pharmacol Toxicol 78 (1996): 117-22
Warot D, Bergougnan L, Lamiable D, et al "Troleandomycin-triazolam interaction in healthy volunteers: pharmacokinetic and psychometric evaluation." Eur J Clin Pharmacol 32 (1987): 389-93
Mattila MJ, Idanpaanheikkila JJ, Tornwall M, Vanakoski J "Oral single doses of erythromycin and roxithromycin may increase the effects of midazolam on human performance." Pharmacol Toxicol 73 (1993): 180-5

Clarithromycin Tablets

Generic Name: clarithromycin

Brand name: Biaxin, Biaxin XL

Synonyms: Clarithromycin

What is Clarithromycin Tablets?

Xanax

Generic Name: alprazolam

Brand name: Niravam, Xanax, Xanax XR, Alprazolam Intensol

Synonyms: n.a.

What is Xanax?

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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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