STOP — Contraindicated
FDA contraindication on ranolazine label. Strong CYP3A4 inhibitors contraindicated due to QT prolongation risk from elevated ranolazine levels.
Evidence level: STRONG
Clarithromycin is contraindicated with ranolazine (Ranexa) because it dramatically increases ranolazine levels, which can prolong the QT interval and cause dangerous heart rhythm problems.
Clarithromycin is a strong CYP3A4 inhibitor. Ranolazine is metabolized by CYP3A4. FDA ranolazine label contraindicates strong CYP3A4 inhibitors. Increased ranolazine levels prolong QT interval.
Do not take clarithromycin with ranolazine. Use alternative antibiotics.
Follow each medication's specific timing instructions. Clarithromycin — check if it requires an empty stomach or should be taken with food. Ranolazine 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).
Dizziness, fainting, palpitations, irregular heartbeat, nausea, constipation
Use alternative antibiotics. If strong CYP3A4 inhibitor is unavoidable, temporarily discontinue ranolazine.
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 is contraindicated with ranolazine (Ranexa) because it dramatically increases ranolazine levels, which can prolong the QT interval and cause dangerous heart rhythm problems.
Follow each medication's specific timing instructions. Clarithromycin — check if it requires an empty stomach or should be taken with food. Ranolazine follows its normal schedule. Complete the full antibiotic course as prescribed.
Dizziness, fainting, palpitations, irregular heartbeat, nausea, constipation
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.
Use alternative antibiotics. If strong CYP3A4 inhibitor is unavoidable, temporarily discontinue ranolazine.
Or browse the full interaction database (121,000+ pairs).