Clindamycin Vaginal and Clarithromycin: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Clarithromycin
Clindamycin Vaginal
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 exposure of CYP3A4 substrate and risk for toxicity
Interaction Deep Dive
Use caution with coadministration of clarithromycin, a strong CYP3A4 inhibitor, with drugs extensively metabolized by CYP3A4, as increased plasma concentrations of the CYP3A4 substrate and risk for toxicity may occur12. Consider dose adjustments, when possible, and closely monitor serum concentrations of drugs primarily metabolized by CYP3A4 1.
Why it happens (mechanism)
Inhibition of CYP3A4-substrate metabolism by clarithromycin
Literature reports
2 reports — tap to read
a) In the drug interaction studies, concomitant administration of clarithromycin 500 mg for every 8 hours with omeprazole 40 mg daily to healthy adult subjects resulted in increased steady-state plasma concentrations of clarithromycin [Cmax, AUC (0 to 24), and half-life increases by 30%, 89%, and 34%, respectively] 2.
b) The plasma levels of clarithromycin and 14-OH clarithromycin were increased by the concomitant administration of omeprazole. For clarithromycin, the mean Cmax was 10% greater, the mean Cmin was 27% greater, and the mean AUC (0 to 8) was 15% greater when clarithromycin was administered with omeprazole than when clarithromycin was administered alone. Similar results were seen for 14-OH clarithromycin, the mean Cmax was 45% greater, the mean Cmin was 57% greater, and the mean AUC (0 to 8) was 45% greater 2.
Common questions
Can I take Clindamycin Vaginal and Clarithromycin together?
Increased exposure of CYP3A4 substrate and risk for toxicity Always confirm with your pharmacist or prescriber before making any change.
How serious is the Clindamycin Vaginal 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 "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Clindamycin Vaginal 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 (2)
- Product Information: BIAXIN(R) XL Filmtab(R) oral extended-release tablets, clarithromycin oral extended-release tablets. AbbVie Inc (per FDA), North Chicago, IL, 2018. DailyMed
- Product Information: VOQUEZNA(R) TRIPLE PAK(R) oral kit, vonoprazan oral tablets, amoxicillin oral capsules, clarithromycin oral tablets kit. Phathom Pharmaceuticals (per FDA), Buffalo Grove, IL, 2024. DailyMed
Keep reading about Clarithromycin
Keep reading about Clindamycin Vaginal
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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