Clarithromycin and Darunavir interaction
Clarithromycin and Darunavir: both prescribing labels flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.
Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.
What the FDA labels say
From the Clarithromycin label · effective 2026-01-01
Doses of clarithromycin greater than 1000 mg per day should not be co-administered with protease inhibitors.
Clarithromycin and other macrolides are known to inhibit CYP3A and Pgp.
Clarithromycin and other macrolides are known to inhibit CYP3A.
From the Darunavir (PREZISTA) label · effective 2025-08-29
For co-administration of clarithromycin and PREZISTA/ritonavir in patients with renal impairment, the following dose adjustments should be considered: For subjects with CLcr of 30–60 mL/min, the dose of clarithromycin should be reduced by 50%.
For subjects with CLcr of <30 mL/min, the dose of clarithromycin should be reduced by 75%.
Co-administration of darunavir and ritonavir and other drugs that inhibit CYP3A, or P-gp may decrease the clearance of darunavir and ritonavir and may result in increased plasma concentrations of darunavir and ritonavir (see Table 10 ).
If the antiretroviral regimen must be withheld for a prolonged period, consideration should be given to initiating a revised regimen that does not include a CYP3A or P-gp inhibitor.
The specific recommendations are based on indication, renal function, and effect of the co-administered P-gp inhibitors on the concentration of dabigatran or edoxaban.
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Open in the checkerNot medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.