Drug & supplement interaction

Cinchona + Clarithromycin

Clarithromycin brand names: Biaxin, Biaxin XL.

Moderate Interaction
The bottom line Moderate

Cinchona has a moderate interaction with Clarithromycin. Theoretically, taking cinchona with other QT interval-prolonging drugs might cause an additive effect and increase the risk of ventricular arrhythmias.

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

Cinchona and Clarithromycin

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

Moderate

QT INTERVAL-PROLONGING DRUGS

Why this applies to Clarithromycin

Clarithromycin falls under QT INTERVAL-PROLONGING DRUGS — the group Cinchona interacts with.

Theoretically, taking cinchona with other QT interval-prolonging drugs might cause an additive effect and increase the risk of ventricular arrhythmias.
Quinidine and quinine, which are constituents of cinchona, prolong the QT interval.
Severity Moderate 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 concern with these two together. Clarithromycin is one of those antibiotics that can stretch out the heart's electrical reset time, something doctors call the QT interval. Cinchona bark naturally contains quinine and quinidine, which do the very same thing. Stack them, and the effects can add up, which in theory raises the risk of an irregular heartbeat (a ventricular arrhythmia).

I'll be honest with you: this is a theoretical caution based on how these compounds behave, not a flood of real-world reports. Still, both can affect heart rhythm, so it's worth taking seriously, especially if you have a known heart condition or take other rhythm-affecting drugs. Don't change anything on your own. Just run it by your pharmacist or doctor first.

References
  1. Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.

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

Cinchona Also Interacts With Other Medications

Cinchona has 3 major, 472 moderate, 16 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 Cinchona

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

From our Q&A

Questions About Cinchona 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 Cinchona 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 Cinchona 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 Cinchona as Part of a Dietary Supplement Product? Check It for Interactions

We hold 12 real supplement products containing Cinchona, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Cinchona. Your product may carry other ingredients that interact with Clarithromycin too, on top of Cinchona — 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 Cinchona 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 Cinchona
Steady interest

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

29 days ago today
Medication Clarithromycin
Top 25%

#444 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 Cinchona

What is Cinchona?

Cinchona
  • Malaria (historical/traditional)
  • Fever
  • Leg cramps and restless legs
  • Digestive upset and loss of appetite
  • Bitter tonic

Cinchona bark is the natural source of quinine and has been used for centuries to treat malaria and fever, but the bark itself is not standardized and can be unpredictable and risky. Modern medicine uses purified, dose-controlled quinine instead, and the supplement form carries real dangers, including serious heart and blood problems. Talk to a pharmacist or doctor before using it, and avoid it during pregnancy.

Read the full Cinchona 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 & Cinchona

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

3Major
472Moderate
16Minor
2,338No known interaction
Major

3 interactions

Moderate

472 interactions

Showing 60 of 472 moderate interactions — see all 472 on the Cinchona page.

Minor

16 interactions

No interaction 2,338 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

Keep exploring
Pharmacist Counseling Corner

Taking Cinchona and Clarithromycin Together: Common Questions

Can you take Cinchona with Clarithromycin?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Cinchona and Clarithromycin interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

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

Still Have a Question About Clarithromycin and Cinchona?

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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.