Prakt. lékáren. 2016; 12(5): 163-169 | DOI: 10.36290/lek.2016.040
Macrolides, their drug-drug interactions and solutions
- Infopharm a. s., Praha
Macrolide antibiotics are the most widely prescribed antibiotics. Athough they are well tolerated, some macrolides can provoke
drug interations by several mechanisms. Clarithromycin and roxithromycin are inhibitors of CYP3A4 and by this mechanism they
increase plasma levels of substrates of CYP3A4. This can harm patients using simvastatin, atorvastatin, verapamil, diltiazem and
other drugs. Clarithromycin also inhibits P-glycoprotein, which increase plasma levels of digoxin, trazodon, sildenafil, omeprazol
and glibenclamid. Clarithromycin and azithromycin prolong QT interval and can cause arrhythmia torsade de pointes, which can
be potentiated by other drugs with similar action, such as amiodarone, sotalol, haloperidol and others. The close cooperation
between pharmacists and prescribing physicians is highly recomended to reduce the drug interaction risk for patients.
Keywords: drug-drug interactions, macrolide antibiotics, statins, digoxin, calcium channel blockers, QT interval
Published: October 1, 2016 Show citation
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