P2Y12 receptor antagonist (antiplatelet)
Clopidogrel with antibiotics: interactions and safety
Antibiotic courses are common, short-term and often combined with chronic medications such as Clopidogrel (Clopidogrel). Most antibiotics do not interfere meaningfully with Clopidogrel at 75mg, 300mg, but a few classes do, and a small number of combinations are best avoided.
Common antibiotic interactions
Macrolides (clarithromycin, erythromycin) and certain antifungals can inhibit hepatic metabolism (CYP3A4) and raise plasma levels of many medications including some P2Y12 receptor antagonist (antiplatelet) agents. Rifampicin has the opposite effect, accelerating metabolism. Most penicillins, cephalosporins, fluoroquinolones and tetracyclines have no clinically meaningful interaction with Clopidogrel at 75mg, 300mg.
Practical guidance
According to the prescribing information for Clopidogrel, an antibiotic course should be reviewed by the prescriber or pharmacist for known interactions before Clopidogrel is co-administered. Adjusted 75mg, 300mg dosing or temporary substitution is sometimes preferred for the duration of the antibiotic course.
Frequently asked questions
Can I take Clopidogrel during an antibiotic course? ▾
For most common antibiotics, yes. A few classes — notably macrolides and azole antifungals — alter how Clopidogrel is metabolised and may need a temporary 75mg, 300mg adjustment. The prescribing pharmacist should review any new antibiotic against the existing Clopidogrel regimen.
Will antibiotics make Clopidogrel stop working? ▾
Most antibiotics do not affect Clopidogrel efficacy. Rifampicin and a few others can lower Clopidogrel levels and reduce effect; in those cases the prescriber may adjust the dose during and shortly after the antibiotic course.
Products containing Clopidogrel
More on Clopidogrel
- With alcoholClopidogrel and alcohol — is it safe to drink?
- With foodShould Clopidogrel be taken with food?
- Side effectsClopidogrel side effects: common, rare and warning signs
- Dosage guideClopidogrel dosage guide: how much to take and when
- OnsetHow fast does Clopidogrel start working?
- DurationHow long does Clopidogrel last?
The information on this website is provided for reference and educational purposes only. It does not replace consultation with a qualified healthcare professional.