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Ranolazine and Clarithromycin Interaction

Drug interaction information between Ranolazine and Clarithromycin.

Ranolazine and Clarithromycin have a documented major interaction in FDA labeling.

FDA drug labeling documents a major-severity interaction between Ranolazine and Clarithromycin. Major interactions are generally avoided, moderate ones may need monitoring or a dose adjustment, and minor ones are usually low-risk. This page shows the documented mechanism and guidance. Label-documented interactions are not a complete safety review, so always confirm your own medications with a pharmacist or doctor. Educational information, not medical advice.

Drug A

Ranolazine

Late Sodium Current Inhibitor (Antianginal)

Drug B

Clarithromycin

Macrolide Antibiotic

How They Interact

Clarithromycin blocks the enzyme that normally clears ranolazine from your system, leading to a dangerous buildup of the medication.

What To Do

This combination should not be used; ask your doctor for a different treatment option.

FDA Label Information

( 7.2 ) 7.1 Effects of Other Drugs on Ranolazine Strong CYP3A Inhibitors Do not use ranolazine with strong CYP3A inhibitors, including ketoconazole, itraconazole, clarithromycin, nefazodone, nelfinavir, ritonavir, indinavir, and saquinavir [see Contraindications (4) , Clinical Pharmacology (12.3) ].

Frequently Asked Questions

Can I take Ranolazine and Clarithromycin together?

This is a major interaction. This combination should not be used; ask your doctor for a different treatment option.

How serious is the interaction between Ranolazine and Clarithromycin?

This interaction is classified as "major" severity by the FDA. Major interactions may be life-threatening or cause serious side effects.

Why do Ranolazine and Clarithromycin interact?

Clarithromycin blocks the enzyme that normally clears ranolazine from your system, leading to a dangerous buildup of the medication.

Understanding the Ranolazine and Clarithromycin Interaction

FDA-approved prescribing information for these two drugs flags their combination as a major-severity interaction. Ranolazine belongs to the Late Sodium Current Inhibitor (Antianginal) class and Clarithromycin belongs to the Macrolide Antibiotic class - two categories that can collide when co-prescribed. The mechanism described in FDA labeling is: Clarithromycin blocks the enzyme that normally clears ranolazine from your system, leading to a dangerous buildup of the medication. Severity tiers matter: major flags generally advise avoidance, moderate flags often require monitoring or dose adjustment, and minor flags may only call for awareness.

Context around a specific patient determines real-world impact. Ranolazine has 31 total documented interactions on file in this dataset, and Clarithromycin has 81. Each additional medication compounds the interaction surface, which is why pharmacists run full-profile checks rather than evaluating one pair at a time. FDA-derived guidance for this pair is: This combination should not be used; ask your doctor for a different treatment option. Timing of doses, renal and hepatic function, age, and other concurrent prescriptions all shape whether a labeled interaction matters clinically.

An interaction flag is not a verdict. A large share of labeled interactions are managed routinely in clinical practice, the fix may be as simple as spacing doses or adding a monitoring test. Others require the prescriber to choose a different medication entirely. This page surfaces FDA-sourced labeling and openFDA data for educational purposes only; it is not medical advice and cannot account for your full clinical picture. Never start, stop, or adjust either Ranolazine or Clarithromycin based on a web page, speak with your prescriber or pharmacist before making any change.

Sources: FDA Drug Labels (SPL) via openFDA (2026). This is for informational purposes only and is not medical advice. Always consult your healthcare provider about drug interactions.