Does Clarithromycin Interact with Apixaban?
Clarithromycin and Apixaban have a moderate drug interaction according to U.S. FDA drug labeling data. Combined P-gp and strong CYP3A4 inhibitor, but pharmacokinetic data suggest no dose adjustment is necessary with concomitant apixaban administration. The mechanism involves cyp3a4 and p-gp inhibition. Patients taking both medications should consult their healthcare provider before starting, stopping, or changing the dosage of either drug. This information is based on official FDA drug labeling sourced from OpenFDA and the NIH National Library of Medicine.
- Severity
- Moderate
- Clarithromycin Class
- Macrolide Antimicrobial
- Apixaban Class
- Factor Xa Inhibitor
- Management
- Monitor for effects
- Data Source
- U.S. FDA via OpenFDA
How This Interaction Works
The interaction between Clarithromycin and Apixaban occurs because cyp3a4 and p-gp inhibition. Clinically, this means combined p-gp and strong cyp3a4 inhibitor, but pharmacokinetic data suggest no dose adjustment is necessary with concomitant apixaban administration. This is classified as a moderate interaction. While it may not require stopping either medication, your healthcare provider should be aware you are taking both so they can monitor for potential effects and adjust treatment if necessary.
What To Tell Your Doctor or Pharmacist
If you are taking Clarithromycin and your doctor is considering prescribing Apixaban (or vice versa), make sure to:
- Inform your doctor and pharmacist of all current medications, including over-the-counter drugs and supplements
- Ask whether the benefits of combining these medications outweigh the risks for your specific situation
- Ask what symptoms to watch for that would indicate the interaction is causing problems
- Ask whether any dosage adjustments are needed
- Never stop or change either medication without first consulting your healthcare provider