Drug & supplement interaction

Squill + Clarithromycin

Clarithromycin brand names: Biaxin, Biaxin XL.

Moderate Interaction
The bottom line Moderate

Squill has a moderate interaction with Clarithromycin. Macrolide antibiotics appear to increase the gastrointestinal absorption of oral digoxin.

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

Squill and Clarithromycin

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

Moderate

MACROLIDE ANTIBIOTICS

Why this applies to Clarithromycin

Clarithromycin falls under MACROLIDE ANTIBIOTICS — the group Squill interacts with.

Macrolide antibiotics appear to increase the gastrointestinal absorption of oral digoxin. Theoretically, concomitant use of macrolide antibiotics might increase the absorption of the cardiac glycosides found in squill.
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 when squill and clarithromycin are taken together. Squill contains heart-acting compounds called cardiac glycosides, which work a lot like the prescription drug digoxin. Clarithromycin can change the gut bacteria that normally break down these glycosides, and it may slow how fast your body clears them. The result, in theory, is that more of squill's heart chemicals get absorbed and stay in your system longer.

If those compounds build up, you could see signs of cardiac glycoside toxicity: nausea, vomiting, vision changes, confusion, or a dangerously slow or irregular heartbeat. I'll be honest, this is a theoretical interaction based on how the drugs behave, not strong studies. Still, squill is risky on its own, so please don't combine these without talking to your pharmacist or doctor first.

References
  1. Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.

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

Squill Also Interacts With Other Medications

Squill has 1 major, 154 moderate 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 Squill

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

From our Q&A

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

We hold 2 real supplement products containing Squill, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Squill. Your product may carry other ingredients that interact with Clarithromycin too, on top of Squill — 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 Squill 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 Squill
Top half

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

29 days ago today
Medication Clarithromycin
Top half

#774 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 Squill

What is Squill?

Squill
  • Cough and chest congestion
  • Fluid retention (diuretic)
  • Heart conditions (traditional 'cardiac tonic')
  • Hair loss (topical use)
  • Rodenticide (red squill, non-medicinal)

Squill is a bulb plant that contains potent cardiac glycosides, which can affect the heart much like the drug digoxin. While it has a long history of use as a cough remedy and heart tonic, it can be dangerously toxic and there is little solid evidence for its modern use, so we do not recommend taking it without close medical supervision.

Read the full Squill monograph & all interactions
Medication

About Clarithromycin

What Is Clarithromycin Used For?

Brand names: Biaxin, Biaxin XL

Clarithromycin treats mild to moderate infections caused by susceptible bacteria. It does not work against viruses.

Not every product is approved for every use. Clarithromycin extended-release tablets are approved only for three infections in adults: flare-ups of chronic bronchitis caused by bacteria, acute sinus infection (maxillary sinusitis), and community-acquired pneumonia. Clarithromycin tablets and oral suspension cover a wider list, including throat and tonsil infections, skin infections, and ear infections in children. H. pylori treatment is listed for the tablets only.

See full Clarithromycin drug information
Keep checking

Other Drugs & Squill

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

1Major
154Moderate
0Minor
2,674No known interaction
Major

1 interaction

Moderate

154 interactions

Showing 60 of 154 moderate interactions — see all 154 on the Squill page.

No interaction 2,674 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 Squill and Clarithromycin Together: Common Questions

Can you take Squill 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 Squill 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

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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.