whether it's safe to combine a calcium channel blocker with a macrolide antibiotic

There's new concern about whether it's safe to combine a calcium channel blocker with a macrolide antibiotic.

Clarithromycin and erythromycin are CYP3A4 inhibitors and therefore can inhibit the metabolism of calcium channel blockers (amlodipine, diltiazem, etc).

This can boost serum levels of the calcium channel blocker...and possibly increase its effects. For example, erythromycin more than DOUBLES levels of felodipine.

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