CriticalProkinetic, 5-HT4 serotonin receptor agonist (withdrawn EU/US)×Macrolide antibiotic
Updated · Methodology
Mechanism
Clarithromycin inhibits CYP3A4 – cisapride rises 5-7 fold. Well-known fatal combination, the main reason for cisapride withdrawal in 2000.
Symptoms
Torsades de pointes, sudden cardiac death.
Management
Combination contraindicated.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.
Summary of a multi-drug list →
Medicine list: everything you take in one place →
Sources
- FDA: Propulsid (cisapride) prescribing information withdrawal (2000)– FDA withdrawal letter, 2000
- AEMPS: Ficha técnica: Claritromicina (nº registro 75638), sección 4.3 (2025)– AEMPS, CIMA, nº registro 75638, revisión 03/2025, sección 4.3