Olaparib and erythromycin

Has anybody come across the issue of erythromycin making the effect of Olaparib stronger? I’ve been put on a tiny dose of the antibiotic to protect my gut but my oncology team have halved my Olaparib. Seems a big drop in the important drug for half a baby’s dose of antibiotic.

[Lindaura]

Hi Grancie,

This is obviously a problem.

Many of us are missing our spleens, which are necessary mainly for our immune systems.

Therefore many ladies are taking prophylactic Antibiotics, so this will definitely affect them.

I have been without a spleen since I was 19 years old, but chose to keep a supply of super antibiotics on hand for emergency use and I have always kept myself safe that way.

So, I am lucky that my GP has gone along with this and I would advise other ladies recently deprived of their own spleens, to work this method out with their own GP.

Meanwhile, this is all I have found on this;

Problems with Ilaparub and the following:

Amoxicillin; Clarithromycin; Lansoprazole: (Major) Avoid coadministration of olaparib with clarithromycin and consider alternative agents with less CYP3A4 inhibition due to increased olaparib exposure. If concomitant use is unavoidable, reduce the dose of olaparib tablets to 100 mg twice daily; reduce the dose of olaparib capsules to 150 mg twice daily. Olaparib is a CYP3A4/5 substrate and clarithromycin is a strong CYP3A4 inhibitor.

Amoxicillin; Clarithromycin; Omeprazole: (Major) Avoid coadministration of olaparib with clarithromycin and consider alternative agents with less CYP3A4 inhibition due to increased olaparib exposure. If concomitant use is unavoidable, reduce the dose of olaparib tablets to 100 mg twice daily; reduce the dose of olaparib capsules to 150 mg twice daily. Olaparib is a CYP3A4/5 substrate and clarithromycin is a strong CYP3A4 inhibitor.

Hope this helps,

Laura

[LittleSan]

I check every drug I'm given with an online interaction checker. I get concerned that with drugs being prescribed from different sources, there may be a time when something is missed. I was being considered for an Olaparib trial but had already searched and found that the low dose Azithromycin I am on for lung damage would have been contraindicated. We can't do the professionals job for them but it is important to be as aware as we can be. It's also important to keep reminding our professionals of the up to date list of meds we're on.

Thanks for highlighting this. I didn't even think of passing the message on and yet it's so important.

[Hidden in reply to LittleSan]

Many thanks for this information. Can you point me towards the interaction checker please. You’re right, too, I don’t want to do the professionals job nor fall foul of potential complications. Because the meds were put into place very quickly, it was quite difficult to get ahead of the game. Hard work keeping your nose in front in this game! Regards, Grancie x

[LittleSan in reply to Hidden]

I use drugs.com interaction checker but there are many others.

[Hidden in reply to LittleSan]

Thanks. Much appreciated. X

[Katmal-UK]

Been on Olaparib over 5 years, never had this mentioned. Been fortunate not to have needed and antibiotics but not eard of this before.

[Hidden in reply to Katmal-UK]

The info is on the paperwork inside the box. I’m keeping my fingers crossed that there’s an easy resolution. X

[Katmal-UK in reply to Hidden]

Not sure what you mean by box but maybe ill ask my onc at next visit. would have thought it would have been mentioned .