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Related Experiment Videos

Interaction between midazolam and clarithromycin: comparison with azithromycin

R A Yeates1, H Laufen, T Zimmermann

  • 1Department of Pharmacology, Pfizer R and D Laboratories, Illertissen, Germany.

International Journal of Clinical Pharmacology and Therapeutics
|September 1, 1996
PubMed
Summary
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Clarithromycin significantly interacts with midazolam, increasing its effects and duration. Azithromycin showed no significant interaction with midazolam in healthy volunteers.

Area of Science:

  • Pharmacology
  • Drug Interactions
  • Clinical Pharmacy

Background:

  • Midazolam is a commonly used hypnotic agent.
  • Macrolide antibiotics like clarithromycin and azithromycin are frequently prescribed.
  • Potential interactions between these drug classes require investigation.

Purpose of the Study:

  • To compare the pharmacokinetic and pharmacodynamic interactions between midazolam and clarithromycin versus azithromycin.
  • To assess the clinical significance of these potential drug interactions.

Main Methods:

  • An open-label, randomized crossover study involving 12 healthy volunteers.
  • Administration of clarithromycin or azithromycin followed by midazolam.
  • Measurement of midazolam plasma concentrations and pharmacodynamic effects.

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Main Results:

  • Clarithromycin significantly increased midazolam's AUC (3.57-fold) and prolonged sleep duration (p < 0.05).
  • Azithromycin did not produce statistically significant changes in midazolam's pharmacokinetic or pharmacodynamic parameters.
  • Significant drug interaction identified between midazolam and clarithromycin.

Conclusions:

  • A clinically relevant drug interaction exists between midazolam and clarithromycin.
  • No significant interaction was observed between midazolam and azithromycin.
  • Caution is advised when co-administering midazolam with clarithromycin.