Does Clarithromycin Interact with Nevirapine?
Clarithromycin and Nevirapine have a moderate drug interaction according to U.S. FDA drug labeling data. Nevirapine significantly decreases clarithromycin exposure while increasing 14-OH metabolite concentrations, potentially reducing activity against Mycobacterium avium complex. Alternatives like azithromycin should be considered. The mechanism involves cyp3a/2b6 enzyme induction by nevirapine. 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
- Nevirapine Class
- Human Immunodeficiency Virus 1 Non-Nucleoside Analog Reverse Transcriptase Inhibitor
- Management
- Monitor for effects
- Data Source
- U.S. FDA via OpenFDA
How This Interaction Works
The interaction between Clarithromycin and Nevirapine occurs because cyp3a/2b6 enzyme induction by nevirapine. Clinically, this means nevirapine significantly decreases clarithromycin exposure while increasing 14-oh metabolite concentrations, potentially reducing activity against mycobacterium avium complex. alternatives like azithromycin should be considered. 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 Nevirapine (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