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When using clarithromycin, it is important to be aware of several interactions and precautions to ensure safe and effective use. Here is a summary of critical safety information:

• Drug Interactions:

  • Clarithromycin may interact with methotrexate and several other medications that affect heart rhythm, including amiodarone, disopyramide, dofetilide, pacritinib, pimozide, procainamide, quinidine, and sotalol.
  • Other drugs can influence how clarithromycin is metabolized, such as rifamycins (e.g., rifabutin), efavirenz, and nevirapine, potentially altering its efficacy.
  • Clarithromycin can also slow the elimination of other drugs from the body, affecting their performance. These include colchicine, digoxin, certain erectile dysfunction medications (e.g., sildenafil, tadalafil), ergot alkaloids (e.g., ergotamine, dihydroergotamine), flibanserin, some statins (e.g., lovastatin, simvastatin), tamsulosin, tolvaptan, and ticagrelor.

• Specific Considerations for Lansoprazole:

  • Since lansoprazole reduces stomach acid, it may alter the absorption and effectiveness of certain drugs requiring stomach acid for proper absorption. Affected drugs include atazanavir, erlotinib, levoketoconazole, nelfinavir, pazopanib, rilpivirine, sparsentan, and some azole antifungals like itraconazole, ketoconazole, and posaconazole.
  • Avoid using dexlansoprazole-containing medications while on lansoprazole due to their similarity.

• Laboratory Interference:

  • This medication might affect the results of certain laboratory tests, such as urine glucose tests. It is crucial to inform lab personnel and all healthcare providers about the use of this drug to avoid misinterpretation of test results. Before starting treatment, consult your healthcare provider to discuss any other medications you are taking and receive guidance on managing potential interactions.

Common side effects:

• Diarrhea
• Headache
• Nausea
• Vomiting
• Unusual taste in mouth
• Mild rash

Less common but important to monitor:

• Muscle weakness
• Signs of liver issues
• Yellowing of the eyes or skin
• Dark urine
• Easy bruising or bleeding
• Mood changes
• Symptoms indicative of lupus
• Signs of kidney problems
• Oral thrush
• Yeast infection

Serious side effects:

• Severe intestinal condition due to C. difficile
• Severe allergic reaction

Interactions with high risk of serious adverse effects and should be avoided:

• Methotrexate
• Amiodarone
• Disopyramide
• Dofetilide
• Pacritinib
• Pimozide
• Procainamide
• Quinidine
• Sotalol

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Rifamycins (e.g., rifabutin)
• Efavirenz
• Nevirapine
• Colchicine
• Digoxin
• Sildenafil
• Tadalafil
• Ergotamine
• Dihydroergotamine
• Flibanserin
• Lovastatin
• Simvastatin
• Tamsulosin
• Tolvaptan
• Ticagrelor

Interactions with low risk that usually do not require a change in therapy:

• Atazanavir
• Erlotinib
• Levoketoconazole
• Nelfinavir
• Pazopanib
• Rilpivirine
• Sparsentan
• Azole antifungals (e.g., itraconazole, ketoconazole, posaconazole)
• Dexlansoprazole