Atogepant and Clarithromycin: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Jul 11, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Clarithromycin
Atogepant
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Increased atogepant exposure
Interaction Deep Dive
Coadministration of atogepant with a strong CYP3A4 inhibitor that is also an OATP inhibitor may significantly increase atogepant exposure. In a pharmacokinetic study, coadministration of atogepant with itraconazole (strong CYP3A4 inhibitor) increased atogepant AUC by 5.5-fold and Cmax by 2.15-fold in healthy subjects. And, coadministration of atogepant with a single dose of rifAMPin (OATP inhibitor) increased atogepant AUC by 2.85-fold and Cmax by 2.23-fold in healthy subjects. For episodic migraine or chronic migraine, the recommended dosage of atogepant with a strong CYP3A4 inhibitor that is also an OATP inhibitor is 10 mg once daily1.
Why it happens (mechanism)
Inhibition of CYP3A4-mediated metabolism of atogepant; inhibition of OATP-mediated transport of atogepant
Literature reports
3 reports — tap to read
a) In a pharmacokinetic study, coadministration of atogepant with itraconazole (strong CYP3A4 inhibitor) increased atogepant AUC by 5.5-fold and Cmax by 2.15-fold in healthy subjects 1.
b) Population pharmacokinetic modeling predicts coadministration of atogepant with a moderate or weak CYP3A4 inhibitor will increase atogepant AUC by 1.7- and 1.1-fold, respectively. This suggested change in atogepant exposure is not expected to be clinically relevant 1.
c) In a pharmacokinetic study, coadministration of atogepant with a single dose of rifAMPin (OATP inhibitor) increased atogepant AUC by 2.85-fold and Cmax by 2.23-fold in healthy subjects 1.
Common questions
Can I take Atogepant and Clarithromycin together?
Increased atogepant exposure Always confirm with your pharmacist or prescriber before making any change.
How serious is the Atogepant and Clarithromycin interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Atogepant or Clarithromycin need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (1)
- Product Information: QULIPTA(R) oral tablets, atogepant oral tablets. AbbVie Inc (per FDA), North Chicago, IL, 2025. DailyMed
Keep reading about Clarithromycin
Keep reading about Atogepant
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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