Does Rivaroxaban Interact with Clarithromycin?
Rivaroxaban and Clarithromycin have a minor drug interaction according to U.S. FDA drug labeling data. Combined P-gp and strong CYP3A inhibitor, but pharmacokinetic data suggests no precautions necessary as exposure change unlikely to affect bleeding risk. The mechanism involves inhibition of cyp3a4/5 and p-gp transporters. 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
- Minor
- Rivaroxaban Class
- Factor Xa Inhibitor
- Clarithromycin Class
- Macrolide Antimicrobial
- Management
- Generally manageable
- Data Source
- U.S. FDA via OpenFDA
How This Interaction Works
The interaction between Rivaroxaban and Clarithromycin occurs because inhibition of cyp3a4/5 and p-gp transporters. Clinically, this means combined p-gp and strong cyp3a inhibitor, but pharmacokinetic data suggests no precautions necessary as exposure change unlikely to affect bleeding risk. This is classified as a minor interaction with generally low clinical significance, though your healthcare provider should still be informed that you are taking both medications.
What To Tell Your Doctor or Pharmacist
If you are taking Rivaroxaban and your doctor is considering prescribing Clarithromycin (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
- Never stop or change either medication without first consulting your healthcare provider