Clarithromycin/Selected Protease Inhibitors; Cobicistat Interactions

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

Your protease inhibitor may slow down how your body processes your antibiotic.

What might happen:

The levels of the antibiotic in your blood may increase. If you have kidney problems, the increased levels may cause toxicities.

What you should do about this interaction:

Let your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together and if you have any kidney problems. Your doctor may want to test your blood to check your kidneys. Your doctor may want to change the dose of your antibiotic.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

  • 1.Reyataz (atazanavir sulfate) US prescribing information. Bristol-Myers Squibb Company November, 2023.
  • 2.Reyataz (atazanavir sulfate) Australian product information. Bristol-Myers Squibb Pharmaceuticals October 25, 2023.
  • 3.Biaxin (clarithromycin) US prescribing information. AbbVie, Inc. September, 2019.
  • 4.Norvir (ritonavir) US prescribing information. Abbott Laboratories December, 2019.
  • 5.Aptivus (tipranavir) US prescribing information. Boehringer Ingelheim Pharmaceuticals, Inc. June, 2020.
  • 6.Prezista (darunavir) US prescribing information. Janssen Therapeutics March, 2023.
  • 7.Kaletra (lopinavir/ritonavir tablets) US prescribing information. Abbott Laboratories December, 2019.
  • 8.Stribild (elvitegravir, cobicistat, emtricitabine, tenofovir) US prescribing information. Gilead Sciences, Inc. September, 2021.
  • 9.Tybost (cobicistat) US prescribing information. Gilead Sciences, Inc. September, 2021.
  • 10.Incivek (telaprevir) US prescribing information. Vertex Pharmaceuticals Incorporated October, 2013.
  • 11.Victrelis (boceprevir) US prescribing information. Schering Corporation January, 2017.
  • 12.Drew BJ, Ackerman MJ, Funk M, Gibler WB, Kligfield P, Menon V, Philippides GJ, Roden DM, Zareba W. Prevention of torsade de pointes in hospital settings: a scientific statement from the American Heart Association and the American College of Cardiology Foundation. J Am Coll Cardiol 2010 Mar 2;55(9):934-47.
  • 13.la Porte CJ, Sabo JP, Elgadi M, Cameron DW. Interaction studies of tipranavir-ritonavir with clarithromycin, fluconazole, and rifabutin in healthy volunteers. Antimicrob Agents Chemother 2009 Jan;53(1):162-73.
  • 14.Brophy DF, Israel DS, Pastor A, Gillotin C, Chittick GE, Symonds WT, Lou Y, Sadler BM, Polk RE. Pharmacokinetic interaction between amprenavir and clarithromycin in healthy male volunteers. Antimicrob Agents Chemother 2000 Apr;44(4):978-84.
  • 15.Boruchoff SE, Sturgill MG, Grasing KW, Seibold JR, McCrea J, Winchell GA, Kusma SE, Deutsch PJ. The steady-state disposition of indinavir is not altered by the concomitant administration of clarithromycin. Clin Pharmacol Ther 2000 Apr;67(4):351-9.
  • 16.Ouellet D, Hsu A, Granneman GR, Carlson G, Cavanaugh J, Guenther H, Leonard JM. Pharmacokinetic interaction between ritonavir and clarithromycin. Clin Pharmacol Ther 1998 Oct;64(4):355-62.

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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.