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:
Clarithromycin and telithromycin may slow down how quickly your liver processes your diabetes medicine.
What might happen:
The amount of your diabetes medicine in your blood may increase and may lower your blood sugar too much.
What you should do about this interaction:
Let your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together. Your doctor may want you to check your blood sugar more closely while you are taking your antibiotic. Let your healthcare professionals know if you experience signs of low blood sugar such as sweating, rapid heartbeat, or dizziness. Your doctor may want to change the dose of your diabetic medicine while you are taking 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.Bussing R, Gende A. Severe hypoglycemia from clarithromycin-sulfonylurea drug interaction. Diabetes Care 2002 Sep;25(9):1659-61.
2.Lilja JJ, Niemi M, Fredrikson H, Neuvonen PJ. Effects of clarithromycin and grapefruit juice on the pharmacokinetics of glibenclamide. Br J Clin Pharmacol 2007 Jun;63(6):732-40.
3.Prandin (repaglinide) US prescribing information. Novo Nordisk Pharmaceuticals, Inc. June, 2009.
4.Niemi M, Neuvonen PJ, Kivisto KT. The cytochrome P4503A4 inhibitor clarithromycin increases the plasma concentrations and effects of repaglinide. Clin Pharmacol Ther 2001 Jul;70(1):58-65.
5.Kajosaari LI, Niemi M, Backman JT, Neuvonen PJ. Telithromycin, but not montelukast, increases the plasma concentrations and effects of the cytochrome P450 3A4 and 2C8 substrate repaglinide. Clin Pharmacol Ther 2006 Mar;79(3):231-42.
6.Khamaisi M, Leitersdorf E. Severe hypoglycemia from clarithromycin-repaglinide drug interaction. Pharmacotherapy 2008 May; 28(5):682-4.