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Cytochrome P450 interactions data available to date indicate Clarithromycin is metabolized primarily by the hepatic cytochrome P450 3A isoenzyme. This is an important mechanism determining many drug interactions. The metabolism of other drugs by this system may be inhibited by concomitant administration with Clarithromycin and may be associated with elevation in serum levels of these other drugs.
The following drugs or drug classes are known or suspected to be metabolized by the same CYP3A isoenzyme: alprazolam, astemizole, carbamazepine, cilostazol, cisapride, cyclosporine, disopyramide, ergot alkaloids, lovastatin, methylprednisolone, midazolam, omeprazole, oral anticoagulants (e.g. warfarin) pimozide, quinidine, rifabutin, sildenafil, simvastatin, tacrolimus, terfenadine, triazolam and vinblastine. Drugs interacting by similar mechanisms through other isoenzymes within the cytochrome P450 system include phenytoin, theophylline and valproate.
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