Clarithromycin: Common Side Effects, Taste Disturbances, and Drug Interactions in Polypharmacy

Clarithromycin is an antibiotic belonging to the macrolides group, widely used in clinical practice to treat various bacterial infections. However, like any medication, its use is not without side effects and precautions, especially in the context of polypharmacy. This article explores the most common side effects of clarithromycin and important considerations when prescribing it alongside other medications.

Side Effects and Considerations in Polypharmacy

Among the most frequent side effects of clarithromycin are nausea, taste disturbances, and gastrointestinal discomfort. These effects can be bothersome for patients but are generally transient and manageable. However, it is crucial to be vigilant about the drug interactions that may arise when clarithromycin is prescribed with other medications.

Clarithromycin is a potent inhibitor of the cytochrome P450 3A4 (CYP3A4) enzyme system, which can increase the blood levels of other drugs metabolized by this pathway, raising the risk of toxicity. A study has shown that clarithromycin can significantly increase the risk of digoxin toxicity, a medication commonly used in patients with heart failure and arrhythmias [1].

Additionally, clarithromycin may interact with other medications such as non-vitamin K oral anticoagulants (NOACs), although in this case, it has been observed that clarithromycin may reduce the risk of major bleeding compared to other medications [2]. However, it is essential to evaluate each case individually, considering the comorbidities and pharmacological profile of the patient.

Conclusions

Clarithromycin is an effective antibiotic, but its use must be carefully considered in the context of polypharmacy due to its potential to cause significant drug interactions. Physicians should be attentive to common side effects such as nausea and taste disturbances, and carefully assess the risk-benefit ratio when prescribing it alongside other medications. Monitoring and dose adjustments may be necessary to avoid serious complications.

Referencias

• [1] Macrolide-induced digoxin toxicity: a population-based study.
• [2] Association Between Use of Non-Vitamin K Oral Anticoagulants With and Without Concurrent Medications and Risk of Major Bleeding in Nonvalvular Atrial Fibrillation.

Created 6/1/2025