MAJOR — Use With Caution
FDA quetiapine label — reduce dose to 1/6 of original with strong CYP3A4 inhibitors. Major overdose risk if not adjusted.
Evidence level: STRONG
Clarithromycin can dramatically increase quetiapine (Seroquel) levels in your blood. The FDA recommends reducing the Seroquel dose to one-sixth of normal when taking strong CYP3A4 inhibitors.
Clarithromycin is a strong CYP3A4 inhibitor. Quetiapine is metabolized by CYP3A4. FDA quetiapine label recommends dose reduction to 1/6th of original dose with strong CYP3A4 inhibitors.
If prescribed clarithromycin while on Seroquel, your Seroquel dose must be drastically reduced (to about 1/6 of normal). Tell your doctor before starting any new antibiotic.
Follow each medication's specific timing instructions. Clarithromycin — check if it requires an empty stomach or should be taken with food. Quetiapine follows its normal schedule. Complete the full antibiotic course as prescribed.
Higher risk for: those with liver or renal impairment, elderly, concurrent use of nephrotoxic or hepatotoxic drugs, history of C. difficile infection, or those on narrow therapeutic index medications (warfarin, digoxin).
Extreme drowsiness, dizziness, low blood pressure, fainting, rapid heartbeat, confusion
Reduce quetiapine to 1/6 dose with strong CYP3A4 inhibitors. Use alternative antibiotics. Readjust dose when antibiotic is completed.
Antibiotic interactions are often temporary (duration of treatment). Space supplements and probiotics 2-3 hours away from antibiotic doses. Ask your pharmacist if timing adjustments can reduce the interaction risk.
Clarithromycin can dramatically increase quetiapine (Seroquel) levels in your blood. The FDA recommends reducing the Seroquel dose to one-sixth of normal when taking strong CYP3A4 inhibitors.
Follow each medication's specific timing instructions. Clarithromycin — check if it requires an empty stomach or should be taken with food. Quetiapine follows its normal schedule. Complete the full antibiotic course as prescribed.
Extreme drowsiness, dizziness, low blood pressure, fainting, rapid heartbeat, confusion
Antibiotic interactions are often temporary (duration of treatment). Space supplements and probiotics 2-3 hours away from antibiotic doses. Ask your pharmacist if timing adjustments can reduce the interaction risk.
Reduce quetiapine to 1/6 dose with strong CYP3A4 inhibitors. Use alternative antibiotics. Readjust dose when antibiotic is completed.
Or browse the full interaction database (121,000+ pairs).