Does Clarithromycin Interact With Rivaroxaban?
Although clarithromycin is a combined P-gp and strong CYP3A inhibitor, pharmacokinetic data suggests that no precautions are necessary with concomitant administration with XARELTO as the change in exposure is unlikely to affect the bleeding risk [see Clinical Pharmacology (12.3) ] .
Severity: Moderate
Severity basis: drug interactions section (keywords: caution). Combining Clarithromycin (Macrolide antibiotic) and Rivaroxaban (Factor Xa inhibitor anticoagulant) is classified as a moderate interaction.
What to Do
Use this combination with caution. Your prescriber may monitor you more closely or adjust doses.
How This Interaction Works
Interactions like this one can happen when two medicines have overlapping effects, or when one changes how the other is absorbed, broken down, or cleared from the body. Clarithromycin is a macrolide antibiotic and Rivaroxaban is a factor xa inhibitor anticoagulant; together they are documented as a moderate interaction. How much this matters depends on your dose, your other medications, and your overall health.
If You Take Both Medications
If you have been prescribed both Clarithromycin and Rivaroxaban, do not start, stop, or change either medication on your own — some medicines are unsafe to stop suddenly. Tell your prescriber and pharmacist that you take both so they can decide whether the combination is right for you, adjust the dose, monitor you more closely, or suggest an alternative.
From the FDA Label
Although clarithromycin is a combined P-gp and strong CYP3A inhibitor, pharmacokinetic data suggests that no precautions are necessary with concomitant administration with XARELTO as the change in exposure is unlikely to affect the bleeding risk [see Clinical Pharmacology (12.3) ] .
Source: FDA structured product labeling (set_id 10db92f9-2300-4a80-836b-673e1ae91610).
Check these against your full medication list in our free Interaction Checker
Frequently Asked Questions
Can you take Clarithromycin and Rivaroxaban together?
Clarithromycin and Rivaroxaban have a documented moderate interaction. Use this combination with caution. Your prescriber may monitor you more closely or adjust doses.
How serious is the Clarithromycin and Rivaroxaban interaction?
It is classified as a moderate interaction, based on the FDA label's drug interactions section (keywords: caution). A moderate interaction can be clinically meaningful and usually calls for monitoring or a dose adjustment.
What should I do if I'm taking both Clarithromycin and Rivaroxaban?
If you have been prescribed both Clarithromycin and Rivaroxaban, do not start, stop, or change either medication on your own — some medicines are unsafe to stop suddenly. Tell your prescriber and pharmacist that you take both so they can decide whether the combination is right for you, adjust the dose, monitor you more closely, or suggest an alternative.
This information is educational — not medical advice.
This page is provided for general educational purposes and summarizes publicly available data from sources such as the U.S. Food & Drug Administration. It is not a substitute for the judgment of a licensed clinician and should not be used to start, stop, or change any medication. It may be incomplete or out of date, and individual circumstances vary. Always talk with your prescriber or pharmacist about your specific medications and health conditions. If you think you may have a medical emergency, call 911.
Other Clarithromycin Interactions
- Clarithromycin + Colchicine(contraindicated)
- Clarithromycin + Lansoprazole(contraindicated)
- Clarithromycin + Lovastatin(contraindicated)
- Clarithromycin + Simvastatin(contraindicated)
- Clarithromycin + Amiodarone(major)
- Clarithromycin + Atorvastatin(major)
- Clarithromycin + Cyclosporine(major)
- Clarithromycin + Fluconazole(major)
- Clarithromycin + Fluticasone Salmeterol(major)
- Clarithromycin + Pioglitazone(major)
- Clarithromycin + Pravastatin(major)
- Clarithromycin + Quetiapine(major)
- Clarithromycin + Ticagrelor(major)
- Clarithromycin + Trazodone(major)
- Clarithromycin + Alprazolam(moderate)
- Clarithromycin + Amlodipine(moderate)
- Clarithromycin + Aripiprazole(moderate)
- Clarithromycin + Carbamazepine(moderate)
- Clarithromycin + Dabigatran(moderate)
- Clarithromycin + Digoxin(moderate)
- Clarithromycin + Diltiazem(moderate)
- Clarithromycin + Glimepiride(moderate)
- Clarithromycin + Itraconazole(moderate)
- Clarithromycin + Nifedipine(moderate)
- Clarithromycin + Phenytoin(moderate)
- Clarithromycin + Rifampin(moderate)
- Clarithromycin + Sildenafil(moderate)
- Clarithromycin + Tacrolimus(moderate)
- Clarithromycin + Tadalafil(moderate)
- Clarithromycin + Valproic Acid(moderate)
- Clarithromycin + Verapamil(moderate)
- Clarithromycin + Warfarin(moderate)
- Clarithromycin + Apixaban(minor)
- Clarithromycin + Eszopiclone(minor)
- Clarithromycin + Lorazepam(minor)
- Clarithromycin + Methylprednisolone(minor)
- Clarithromycin + Omeprazole(minor)
- Clarithromycin + Oxybutynin(minor)
- Clarithromycin + Temazepam(minor)
Other Rivaroxaban Interactions
- Rivaroxaban + Carbamazepine(major)
- Rivaroxaban + Itraconazole(major)
- Rivaroxaban + Ketoconazole(major)
- Rivaroxaban + Phenytoin(major)
- Rivaroxaban + Rifampin(major)
- Rivaroxaban + Aspirin(moderate)
- Rivaroxaban + Clopidogrel(moderate)
- Rivaroxaban + Enoxaparin(moderate)
- Rivaroxaban + Warfarin(moderate)
- Rivaroxaban + Trazodone(minor)