Drug & supplement interaction

Bael + Clarithromycin

Clarithromycin brand names: Biaxin, Biaxin XL.

Minor Interaction
The bottom line Minor

Bael has a minor interaction with Clarithromycin. Bael and its constituents marmelosin and marmesinin inhibited cytochrome P450 3A4 (CYP3A4) activity in vitro.

Read the full interaction report
SeverityMinor
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Bael and Clarithromycin

Here is the interaction we found between these two, with the evidence behind it.

Minor

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

Why this applies to Clarithromycin

Clarithromycin falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Bael interacts with.

Bael and its constituents marmelosin and marmesinin inhibited cytochrome P450 3A4 (CYP3A4) activity in vitro. So far, this interaction has not been reported in humans. Theoretically, bael might increase levels of drugs metabolized by CYP3A4.
Some drugs metabolized by CYP3A4 include lovastatin (Mevacor), ketoconazole (Nizoral), itraconazole (Sporanox), fexofenadine (Allegra), triazolam (Halcion), and numerous others. Use bael cautiously or avoid in patients taking these drugs.
Severity Minor Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the short version: your body uses a liver enzyme called CYP3A4 to help break down clarithromycin. In lab tests, compounds in bael (marmelosin and marmesinin) slowed that same enzyme down. In theory, that could let clarithromycin build up a bit more than usual, which might mean a higher chance of side effects like stomach upset, nausea, a strange or metallic taste, or diarrhea.

The key word here is theoretical. This has only been seen in test-tube studies, never reported in real people, and it's rated as a minor concern. Eating bael as a food is very unlikely to cause trouble. Concentrated supplement doses are the bigger unknown. To be safe, just let your pharmacist or doctor know before pairing the two.

References
  1. Manda VK, Avula B, Chittiboyina AG, Khan IA, Walker LA, Khan SI. Inhibition of CYP3A4 and CYP1A2 by Aegle marmelos and its constituents. Xenobiotica. 2016;46(2):117-25.

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Bael Also Interacts With Other Medications

Bael has 111 moderate, 707 minor known drug interactions in our database — the Clarithromycin one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Bael

Covers the 2,830 medications we’ve checked against Bael. Pick one to open its full report.

From our Q&A

Questions About Bael or Clarithromycin

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Bael or Clarithromycin, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Clarithromycin

This page covers Bael only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Clarithromycin page lists 196 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), Arsenic (major), Cesium (major) and Ephedra (major).

By severity: 9 major · 146 moderate · 41 minor.

Open the Clarithromycin interaction page

One more smart check

Taking Bael as Part of a Dietary Supplement Product? Check It for Interactions

We hold 94 real supplement products containing Bael, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Bael. Your product may carry other ingredients that interact with Clarithromycin too, on top of Bael — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Bael and Clarithromycin Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Bael
Top half

#643 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Clarithromycin
Top 25%

#486 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Bael

What is Bael?

Bael
  • Diarrhea and dysentery
  • Indigestion and other digestive complaints
  • Constipation
  • Blood sugar support
  • General wellness in traditional medicine

Bael is a fruit-bearing tree long used in traditional Indian (Ayurvedic) medicine, mostly for digestive problems like diarrhea and indigestion. Modern human evidence for its medicinal benefits is very limited, so it should be viewed mainly as a food and traditional remedy rather than a proven treatment. Talk to your pharmacist or doctor before using bael as a supplement, especially if you are pregnant, breastfeeding, or have a health condition.

Read the full Bael monograph & all interactions
Medication

About Clarithromycin

What Is Clarithromycin Used For?

Brand names: Biaxin, Biaxin XL

Clarithromycin tablets and oral suspension treat a range of mild to moderate bacterial infections in adults and children, including community-acquired pneumonia, acute sinus infections, acute bacterial flare-ups of chronic bronchitis, strep throat and tonsillitis, uncomplicated skin infections, and middle ear infections in children. Tablets are also used in adults to eliminate H. pylori bacteria (in combination with other medicines) to reduce the risk of duodenal ulcer recurrence.

Clarithromycin tablets — but not the extended-release tablet — are also used to treat and prevent disseminated Mycobacterium avium complex (MAC) infections in people with advanced HIV. Clarithromycin extended-release tablets are approved only for acute bacterial exacerbation of chronic bronchitis, acute maxillary sinusitis, and community-acquired pneumonia in adults — not for the other conditions listed above.

See full Clarithromycin drug information
Keep checking

Other Drugs & Bael

Browse every other medication we’ve checked against Bael — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
111Moderate
707Minor
2,011No known interaction
Moderate

111 interactions

Showing 60 of 111 moderate interactions — see all 111 on the Bael page.

Minor

707 interactions

Showing 60 of 707 minor interactions — see all 707 on the Bael page.

No interaction 2,011 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking Bael and Clarithromycin Together: Common Questions

Can you take Bael with Clarithromycin?
There is only a minor interaction, which is usually not serious. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Bael and Clarithromycin interaction?
We rate it Minor. This interaction is generally not clinically significant, but it remains worth noting and discussing with your pharmacist.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Clarithromycin and Bael?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.