Clarithromycin Ext-rel

See Contraindications. Class IA (disopyramide, quinidine, procainamide) or Class III (dofetilide, amiodarone, sotalol) antiarrhythmics, or other drugs known to prolong QT interval: not recommended. Sildenafil, tadalafil, vardenafil: not recommended. Antagonized by CYP3A inducers (eg, efavirenz, nevirapine, rifampicin, rifabutin, rifapentine, etravirine); use alternative antibacterial treatment. Doses >1000mg/day should not be coadministered with protease inhibitors. Separate zidovudine dose by at least 2hrs. Potentiated by CYP3A inhibitors (eg, itraconazole, saquinavir, atazanavir, ritonavir). Concomitant atazanavir: see Adults; consider alternative antibacterial therapy for indications other than MAC. May potentiate theophylline, omeprazole, phenytoin, digoxin, midazolam, alprazolam, triazolam, cyclosporine, hexobarbital, tacrolimus, alfentanil, bromocriptine, valproate, carbamazepine, tolterodine, itraconazole, methylprednisolone, cilostazol, vinblastine, quetiapine, maraviroc; monitor these and other drugs metabolized by CYP3A. Myopathy/rhabdomyolysis with statins; max 20mg atorvastatin/day, 40mg pravastatin/day; consider use of statin not dependent on CYP3A metabolism (eg, fluvastatin). Reduce colchicine dose if coadministration is necessary. Hypoglycemia with oral hypoglycemics/insulin; carefully monitor glucose. Oral anticoagulants: frequently monitor INR and prothrombin times. Hypotension with calcium channel blockers metabolized by CYP3A4 (eg, verapamil, amlodipine, diltiazem, nifedipine).