Critical
Clarithromycin × Everolimus
Macrolide antibiotic×mTOR kinase inhibitor – immunosuppressant and antineoplastic
Mechanism
Clarithromycin inhibits CYP3A4 and P-gp. Everolimus rises 5+ fold – severe immunosuppression, pneumonitis, nephrotoxicity.
Symptoms
Dyspnoea, rising creatinine, cytopenia.
Management
Combination contraindicated. Alternative – azithromycin.
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.
Sources
- EMA: Certican (everolimus) SmPC (2024)– EMA EPAR Certican