Potential interaction between itraconazole and clarithromycin.
Three patients negative for human immunodeficiency virus infection were admitted for pulmonary Mycobacterium avium complex (MAC) and aspergillosis infections. They were treated with different drug combinations, but all regimens included clarithromycin for MAC and itraconazole for aspergillosis. All patients experienced an increase in clarithromycin concentrations and clarithromycin: 14-OH-clarithromycin ratio compared with expected range values. They had no clinical side effects. The time course suggested a possible interaction between clarithromycin and itraconazole, presumably through itraconazole's effects on cytochrome P450 3A4 activity. A bidirectional interaction cannot be ruled out. The data suggest that, when necessary, these two drugs can be administered together safely. Further investigation is necessary to determine the extent and clinical consequences of coadministration in humans.
Auclair
B
B
Department of Medicine, National Jewish Center for Immunology and Respiratory Medicine, University of Colorado, Denver 80206, USA.
Berning
S E
SE
Huitt
G A
GA
Peloquin
C A
CA
D000328:Adult; D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000627:therapeutic use; D000935:Antifungal Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001228:Aspergillosis / Q000150:complications / Q000188:drug therapy; D017291:Clarithromycin / Q000009:adverse effects* / Q000097:blood / Q000627:therapeutic use; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D017964:Itraconazole / Q000009:adverse effects* / Q000627:therapeutic use; D008172:Lung Diseases, Fungal / Q000150:complications / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D015270:Mycobacterium avium-intracellulare Infection / Q000150:complications / Q000188:drug therapy
D000900:Anti-Bacterial Agents; D000935:Antifungal Agents; D017964:Itraconazole; D017291:Clarithromycin