Loratadine Clarithromycin

Uniflox ciprofloxacin cyproheptadine ciprofloxacin Nimbex zuclopenthixol Cisplatyl, Plasticin, Platiblastin, Platinex, Platinol, Platinol-AQ, Platistil cisplatin praziquantel Celexa prilocaine immune globulin IV busulfan leucovorin cimetidine loratadine clarithromycin Leustatin cefotaxime... 

Drugs that can increase carbamazepine serum levels include cimetidine, danazol, diltiazem, erythromycin, felbamate, clarithromycin, fluoxetine, isoniazid, niacinamide, propoxyphene, ketaconazole, itraconazole, verapamil, valproate, troleandomycin, loratadine, nicotinamide, tricyclic antidepressants, SSRIs, nefazodone, protease inhibitors. 

Qarithromycin (500 mg bd for 10 days) significantly increased the steady-state maximum plasma concentration and the steady-state AUC of loratadine (10 mg/day for 10 days) (92). In contrast, the addition of loratadine did not affect the steady-state pharmacokinetics of clarithromycin or its active metabolite, 14(R)-hydroxyclarithromycin. No QTc interval exceeded 439 ms in any subject. 

Carr RA, Edmonds A, Shi H, Locke CS, Gustavson LE, Craft JC, Harris SI, Palmer R. Steady-state pharmacokinetics and electrocardiographic pharmacodynamics of clarithromycin and loratadine after individual or concomitant administration. Antimicrob Agents Chemother 1998 42(5) 1176-80. 

Erythromycin and propably clarithromycin inhibit this metabolism, and the increased terfenadine serum concentration can result in cardiac arrhythmias (e.g., torsades de pointes). Early evidence suggests that astemizole can produce the same result if combined with erythromycin. Erythromycin also inhibits the metabolism of loratadine however, loratadine does not appear to be cardiotoxic. 

The manufacturers of mizolastine also contraindicate the concurrent use of the macrolides, despite any evidence of a significant interaction. Erythromycin markedly raises ebastine levels causing a modest increase in QT interval. The manufacturer of ebastine advises against concurrent use of the macrolides erythromycin, clarithromycin and josamycin." Erythromycin also raises loratadine levels, which caused a very slight increase in QTc interval in one study. However, no special precautions appear to have been recommended for the use of loratadine with macrolides. Because there are no data on acrivastine with erythromycin, the manufacturer advises caution. ... 

Loratadine 10 mg daily Clarithromycin 500 mg twice daily 10 24 healthy subjects 36% Loratadine 69% Descarbo-etho) loratadine 76% Loratadine 49% Descarbo-ethoxyloratadine Mean increase of 4 milliseconds. Maximum QTc 439 milliseconds 9... 

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