Medication·Interactions & depletion·Reviewed June 9, 2026
Clarithromycin interactions.
Clarithromycin has 5 documented interactions in the NutriStack database, including 2 flagged to avoid or as a serious conflict. Prolonged use is also associated with lower Vitamin K. The full interaction list, depletion table, and replacement suggestions are below. None of this is a substitute for your prescriber's advice.
Clarithromycin at a glance.
A quick, data-grounded summary. The full tables are below.
Clarithromycin has 5 documented interactions in the NutriStack database, including 2 flagged to avoid or as a serious conflict. Prolonged use is also associated with lower Vitamin K. The full interaction list, depletion table, and replacement suggestions are below. None of this is a substitute for your prescriber's advice.
Substances that interact with clarithromycin.
Every supplement and medication in the NutriStack database with a documented interaction with this drug, highest-severity first. Open any pair for the mechanism and sources.
| Substance | Interaction | What happens |
|---|---|---|
| Simvastatin | Contraindicated | Clarithromycin is a potent CYP3A4 inhibitor that dramatically increases simvastatin plasma levels (up to 10-fold), greatly increasing the risk of... details → |
| St. John's Wort | Conflict | St. John's Wort is a potent inducer of CYP3A4, the primary enzyme that metabolizes clarithromycin. Co-administration substantially lowers... details → |
| Atorvastatin | Caution | Clarithromycin inhibits CYP3A4, increasing atorvastatin levels. While less dramatic than simvastatin interaction (atorvastatin is partially CYP3A4... details → |
| Probiotics | Synergy | Probiotic supplementation during clarithromycin therapy, including during H. pylori triple therapy, reduces antibiotic-associated diarrhea and... details → |
| Saccharomyces Boulardii | Synergy | Saccharomyces boulardii reduces antibiotic-associated diarrhea during clarithromycin therapy and is unaffected by the antibiotic because it is a... details → |
What clarithromycin can deplete.
Nutrients this medication is associated with lowering over time, with the mechanism, a suggested replacement where one applies, and the biomarker to monitor. Discuss any replacement with your prescriber first.
| Nutrient | Severity | How it happens | Replace with | Monitor |
|---|---|---|---|---|
| Vitamin K | Mild | Broad-spectrum antibiotic exposure can suppress gut bacteria that synthesize menaquinones, lowering vitamin K availability in susceptible patients. | – | PT/INR |
The full clarithromycin profile.
Uses, typical dosing, side effects, and the cited evidence for this medication.
Common clarithromycin questions.
Quick answers drawn from the tables above.
What interacts with Clarithromycin?
In the NutriStack database, Clarithromycin has 5 documented interactions. The most notable include Simvastatin, St. John's Wort, Atorvastatin, Probiotics, and Saccharomyces Boulardii. Check any specific combination before taking it and confirm with your prescriber.
Which substances should I avoid with Clarithromycin?
Clarithromycin is flagged against 2 substances in the database, including Simvastatin and St. John's Wort. These pairings carry a higher risk and should be reviewed with a clinician before combining.
Does Clarithromycin deplete any nutrients?
Clarithromycin is associated with lowering Vitamin K with prolonged use. Useful biomarkers to monitor include PT/INR. Ask your prescriber before adding any replacement supplement.
Is it safe to take Simvastatin with Clarithromycin?
NutriStack classifies the Simvastatin and Clarithromycin pairing as contraindicated: Clarithromycin is a potent CYP3A4 inhibitor that dramatically increases simvastatin plasma levels (up to 10-fold), greatly increasing the risk of severe rhabdomyolysis,... Contraindicated. Suspend simvastatin during clarithromycin treatment. If statin therapy is needed, use pravastatin or rosuvastatin (not CYP3A4... Always confirm with your prescriber.
Check your whole stack
See how clarithromycin fits your supplements.
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