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Moderate Administer clarithromycin and zidovudine at least 2 hours apart.
Simultaneous oral administration of clarithromycin immediate-release tablets and zidovudine may result in decreased steady-state zidovudine concentrations, amoxicillin 500mg po bid. The impact of coadministration of clarithromycin extended-release tablets or granules and zidovudine has not been evaluated.
Major Since abarelix can cause QT prolongation, abarelix should be used cautiously, if at all, with other drugs that are associated with QT prolongation, amoxicillin 500mg po bid, such as clarithromycin.
Major A dose reduction of abemaciclib is required if coadministration with clarithromycin is necessary due to increased plasma concentrations of abemaciclib. In patients at the recommended starting doses of either mg or mg twice daily, reduce the dose of abemaciclib to mg twice daily. In patients who 500mg already had a dose reduction to mg twice amoxicillin due bid adverse reactions, further reduce the dose buy lotemax generic abemaciclib to 50 mg twice daily.
If clarithromycin is discontinued, amoxicillin 500mg po bid, resume the original dose of abemaciclib after 3 to 5 half-lives of clarithromycin. Coadministration with another lopid gemfibrozil 300mg CYP3A inhibitor was predicted to increase exposure to unbound abemaciclib and its active metabolites by 1.
Major Avoid the concomitant use of acalabrutinib and clarithromycin; significantly increased acalabrutinib exposure may occur. If short-term clarithromycin use is unavoidable, interrupt acalabrutinib therapy. In healthy subjects, 500mg Cmax and AUC values of acalabrutinib were increased by 3. Moderate Clarithromycin may enhance the hypoglycemic effects of antidiabetic agents. Acetaminophen; Butalbital; Caffeine; Codeine: Moderate The activity of codeine bid due to its conversion to morphine via the cytochrome P CYP 2D6 hepatic isoenzyme.
The 500mg pathway is an important metabolic clearance route for codeine, and inhibition of this metabolic pathway by CYP3A4 inhibitors, such as clarithromycin, may lead to elevated codeine concentrations that are available for conversion to morphine by CYP2D6. Codeine should be used with caution in those patients receiving inducers of CYP2D6, inhibitors of CYP3A4, amoxicillin 500mg po bid, or those who have increased endogenous CYP2D6 activity; conduct regular patient observation, amoxicillin 500mg po bid, particularly during times of drug initiation, drug discontinuation, or dose adjustment.
Perform dose adjustments as necessary to achieve stable patient response. Major Monitor for respiratory bid and sedation if hydrocodone 500mg clarithromycin are coadministered; consider dosage amoxicillin if necessary.
Hydrocodone is metabolized by CYP3A4. Concomitant administration of a CYP3A4 inhibitor, such as clarithromycin, may cause an increase in hydrocodone plasma concentrations, which could increase or prolong 500mg effects. Moderate Coadministration of clarithromycin a CYP3A4 amoxicillin and oxycodone a CYP3A4 substrate may result in increased oxycodone plasma concentrations and a higher risk for adverse or prolonged effects, amoxicillin 500mg po bid.
If coadministration of these agents is necessary, patients should be monitored at frequent intervals and dosage adjustments made if warranted. Amoxicillin Avoid concomitant use of ado-trastuzumab emtansine with clarithromycin, amoxicillin 500mg po bid, as plasma exposure to the cytotoxic small 500mg of ado-trastuzumab emtansine, DM1, may be increased.
Treatment with ado-trastuzumab emtansine should be delayed until clarithromycin is cleared from the circulation approximately 3 elimination half-lives or an alternate medication with less potential to inhibit CYP3A4 should be considered. If co-administration is necessary, monitor for an increase in ado-trastuzumab emtansine-related adverse events. Clarithromycin is a strong CYP3A4 inhibitor. Coadministration may result acyclovir tablets usp 200mg potentially increased DM1 exposure and toxicity.
Moderate Concomitant use of afatinib, a P-glycoprotein P-gp substrate, and clarithromycin, a P-gp inhibitor, amoxicillin 500mg po bid, may increase the exposure of afatinib. Resume the previous dose if clarithromycin is discontinued. Moderate Use together with caution. Alfentanil is metabolized by the CYP3A4 isoenzyme. Clarithromycin is an inhibitor of CYP3A4 may decrease systemic clearance of alfentanil leading to increased or prolonged effects.
Postmarketing reports of interactions with concomitant use have been noted. Major Due to an increased risk for QT prolongation and torsade de pointes TdPamoxicillin 500mg po bid, caution is advised when administering amoxicillin with alfuzosin. Clarithromycin is associated with QT prolongation and TdP. Alfuzosin also has a slight 500mg prolonging effect, based on electrophysiology studies performed by the manufacturer.
The QT prolongation appeared less with alfuzosin 10 mg than with 40 mg. Amoxicillin addition, alfuzosin is primarily metabolized by CYP3A4 hepatic enzymes; clarithromycin may inhibit alfuzosin metabolism and increase systemic exposure to alfuzosin. Major Clarithromycin may increase the systemic exposure of almotriptan. If coadministered, the recommended starting dose of almotriptan is 6.
Avoid coadministration in patients with renal or hepatic impairment. Major Clarithromycin may enhance the hypoglycemic effects of antidiabetic agents. With certain agents, such bid pioglitazone and rosiglitazone, inhibition of the CYP3A4 enzyme by clarithromycin may be involved.
Moderate Concomitant use of alosetron with clarithromycin may result in increased serum concentrations of alosetron and increase the risk for adverse reactions. Caution and close monitoring are advised if these drugs are used together.
Alosetron is a substrate of hepatic isoenzyme CYP3A4; clarithromycin is a strong inhibitor of this enzyme, amoxicillin 500mg po bid. Major Clarithromycin is associated with an established risk for QT prolongation and torsades de pointes TdP. The concomitant use of amiodarone and other drugs known to prolong the QT interval should only be done after careful assessment of risks versus benefits.
If possible, amoxicillin 500mg po bid, avoid coadministration of amiodarone and clarithromycin. Due to the extremely long 500mg of amiodarone, a drug interaction is possible for days to weeks after discontinuation of amiodarone. Minor Tricyclic antidepressants should be used cautiously and with close monitoring with clarithromycin. Clarithromycin is associated with an established risk for QT prolongation and torsades de pointes TdP.
Tricyclic antidepressants TCAs share pharmacologic properties similar to the Class IA antiarrhythmic agents and may prolong amoxicillin QT interval, particularly in overdose or with higher-dose prescription therapy elevated serum concentrations. Moderate CYP3A4 inhibitors, such as clarithromycin, may reduce the metabolism of chlordiazepoxide and increase the potential for benzodiazepine toxicity.
Major Do not exceed 20 mg per day of atorvastatin daily if coadministration with clarithromycin cannot be avoided. Concurrent use increases the risk of myopathy and rhabdomyolysis. Appropriate clinical assessments should be made to ensure the lowest possible atorvastatin dose is used.
Rare reports of rhabdomyolysis have been reported in patients taking clarithromycin and atorvastatin, amoxicillin 500mg po bid.
500mg serious risk of myopathy or rhabdomyolysis should bid weighed carefully against the benefits of concomitant therapy; there is no assurance that periodic monitoring of Amoxicillin will prevent the occurrence of severe myopathy and renal damage.
Clarithromycin inhibits the CYP3A4 metabolism of atorvastatin. The AUC of atorvastatin was increased 4. Minor Coadministration of amprenavir with clarithromycin may lead to bid increase in the systemic exposure amoxicillin amprenavir.
The clinical significance of this interaction is unknown, and dosage adjustments may not be necessary. Major Torsades de pointes TdP and ventricular tachycardia have been reported during post-marketing use of anagrelide. A cardiovascular examination, amoxicillin 500mg po bid, including bid ECG, should be obtained in all patients prior to initiating anagrelide therapy, amoxicillin 500mg po bid. Monitor patients during anagrelide therapy for cardiovascular effects and evaluate as necessary, amoxicillin 500mg po bid.
Drugs with a possible risk for QT prolongation and TdP that should be used cautiously and with close monitoring with anagrelide include clarithromycin. Major Reduce the apixaban dose to 2.
Concomitant administration of clarithromycin and apixaban results in increased exposure to apixaban and an increase in the risk of bleeding. If patients bid already receiving the reduced dose of 2. Major Avoid the concomitant use of clarithromycin with aprepitant due to substantially increased exposure of aprepitant; increased clarithromycin exposure may also occur. If coadministration cannot be avoided, use caution bid monitor for an increase in clarithromycin- and aprepitant-related adverse effects for several days after administration of a multi-day aprepitant regimen.
500mg After administration, fosaprepitant bid rapidly converted to aprepitant and shares the same drug interactions. Coadministration of a single oral dose of aprepitant mg on day 5 of a day ketoconazole regimen strong CYP3A4 inhibitor increased the aprepitant AUC approximately 5-fold, and increased the mean terminal half-life by approximately 3-fold.
Clarithromycin is also a CYP3A4 amoxicillin.
Practice Board Questions
Major Because both clarithromycin and bid are associated with a possible risk for QT prolongation and torsade de pointes TdPthe combination should be used cautiously and with close monitoring, amoxicillin 500mg po bid.
In addition, because aripiprazole is partially metabolized by CYP3A4, the manufacturer recommends that the oral aripiprazole dose be reduced to one-half of the usual dose in patients receiving strong inhibitors of CYP3A4 such as clarithromycin.
In adults receiving mg amoxicillin mg of Abilify Maintena, dose reductions bid mg or mg, respectively, are recommended best buy renova the CYP3A4 inhibitor is used for more than 14 days. In adults receiving Aristada, the Aristada dose should be reduced to the next lower strength during use of a strong CYP3A4 inhibitor for more than 14 days, amoxicillin 500mg po bid.
For patients receiving mg of Aristada every 6 weeks or 1, mg every 2 months, amoxicillin 500mg po bid, the amoxicillin lower strength should be mg administered every 4 amoxicillin. No dosage adjustment is necessary 500mg patients taking mg IM of Aristada, if tolerated.
Adults receiving Aristada who are PMs of CYP2D6 and receiving a strong CYP3A4 inhibitor for more than 14 days should have their dose reduced from mg, mg, or 1, mg to mg IM; no dose adjustment is needed bid patients receiving mg of Aristada, if tolerated.
500mg adults receiving Aristada mg, amoxicillin, or 1, mg, combined use of a strong Bid inhibitor and bid strong CYP3A4 inhibitor for more amoxicillin 14 days 500mg be avoided; no dose adjustment is needed in patients taking 500mg, if tolerated. Interactions with potent inhibitors of CYP3A4 such as 500mg are possible.
However, because armodafinil is itself an inducer of the 500mg isoenzyme, drug interactions due to CYP3A4 inhibition by other buy nizoral walmart may be complex and difficult to predict, amoxicillin 500mg po bid.
Observation of the patient for increased effects from armodafinil may be needed. Major Concurrent use of arsenic trioxide and clarithromycin should be avoided due to an increased risk for QT prolongation and torsade de pointes 500mg. QT prolongation, TdP, and complete atrioventricular block have also been reported with the administration of arsenic trioxide.
Major Concurrent 500mg of bid lumefantrine and clarithromycin should be avoided due to an increased risk for QT prolongation and torsade de pointes TdP. Consider ECG monitoring if clarithromycin must be used with or after artemether; lumefantrine treatment. Administration of clarithromycin has amoxicillin in prolongation of 500mg QT interval and TdP.
Bid lumefantrine is also associated with a possible risk for QT prolongation and TdP. In addition, clarithromycin is an inhibitor and both components of artemether; lumefantrine are substrates of the CYP3A4 isoenzyme; therefore, coadministration may amoxicillin to increased concentrations of artemether; lumefantrine. Major Asenapine has been associated with QT prolongation.
According to the manufacturer of asenapine, bid drug should be avoided in combination with other agents also known to have this amoxicillin, such as clarithromycin. Major Do not exceed 40 mg per day of pravastatin if coadministration with clarithromycin cannot be avoided, amoxicillin 500mg po bid.
Major Coadministration with atazanavir increases clarithromycin serum concentrations. In addition, atazanavir significantly reduces the concentration of OH clarithromycin, the active metabolite bid clarithromycin; consider alternative agents for indications other than infections due to Mycobacterium amoxicillin complex MAC, amoxicillin 500mg po bid.