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In an application with several zidovudine reduces the bioavailability of zidovudine.
Colchicine is a substrate of CYP3A, and P-glycoprotein. It is known that clarithromycin and other macrolides are inhibitors of CYP3A and P-glycoprotein. When co-administered clarithromycin and colchicine P-glycoprotein inhibition and / or CYP3A can lead to increased action of colchicine. It is necessary to monitor the development of the clinical symptoms of colchicine poisoning. Registered post-marketing reports of colchicine poisoning cases when concomitantly with clarithromycin, mostly in elderly patients. Some of the reported cases occurred in patients with renal insufficiency. As reported, some cases are fatal. Concomitant use of clarithromycin and colchicine is contraindicated.
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In a joint application of midazolam and clarithromycin (oral 500 mg 2 times / day), showed an increase in AUC of midazolam: 2.7 times after i / v administration of midazolam and 7-fold after oral administration. Simultaneous administration of midazolam with clarithromycin for oral use is contraindicated. If used together with clarithromycin / in the form of midazolam, the patient should be carefully monitored for the possible state of dose adjustment.
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The same precautions should also apply to other benzodiazepines that are metabolized of CYP3A, including triazolam and alprazolam. For benzodiazepines, removal of which is not dependent on CYP3A (temazepam, nitrazepam, lorazepam), a clinically significant interaction unlikely with clarithromycin.
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