Drug intelligence / Profile preview

rifampicin + clarithromycin

Development stage
Unknown
Modality
Small Molecules
Administration
Oral, Intravenous
01

Overview

Rifampicin + clarithromycin is a combination of two antibiotics used primarily for the treatment of infections caused by certain bacteria, including nontuberculous mycobacteria (NTM) such as *Mycobacterium avium* complex (MAC) and *Rhodococcus equi*. Rifampicin is a member of the rifamycin group and acts by inhibiting bacterial DNA-dependent RNA polymerase, thereby blocking RNA synthesis in bacteria[6]. Clarithromycin is a macrolide antibiotic that inhibits bacterial protein synthesis by binding to the 50S ribosomal subunit. The combination has been shown to be more effective than either drug alone in animal models of chronic infection[4], and it is commonly used in veterinary medicine for foals with *R. equi* pneumonia[5]. In humans, this combination is also used for NTM infections when azithromycin cannot be used or when CYP substrate interactions are relevant[3]. However, significant pharmacokinetic interactions occur between these drugs due to their opposing effects on CYP3A enzymes: rifampicin induces CYP3A activity while clarithromycin inhibits it, leading to reduced exposure to clarithromycin during co-administration[2][8].

Other names
standard (RC)
02

Targets

rpoB (DNA-directed RNA polymerase subunit beta)Bacterial 50S ribosomal subunit

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