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A drug combination where clarithromycin, a macrolide antibiotic, significantly inhibits the metabolism of vinorelbine, a semi-synthetic vinca alkaloid used in cancer treatment. This interaction occurs through clarithromycin's inhibition of CYP3A and P-glycoprotein, which can lead to increased vinorelbine blood levels and potentially severe neutropenia. Clinical evidence shows patients receiving both drugs concurrently had significantly higher incidence of grade 4 neutropenia (31.6%) compared to those receiving vinorelbine alone (2.5%).
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