Researchers say combining popular hypertensive drug and antibiotic can damage kidneys.

A new study presented at the recent American Society of Nephrology Renal Week conference in Atlanta, Ga., warns that a common drug used to lower high blood pressure might interact with an antibiotic and cause rare, but serious kidney injury.

Senior study author, Dr. Amit Garg, said in a press statement that a review of Ontario’s health records show that despite warnings against combining the antibiotic clarithromycin and calcium channel blockers commonly used as anti-hypertensives, “they have been prescribed nearly 100,000 times in the past decade.”

The study authors compared rates of hospitalization for acute kidney injury, dangerously low blood pressure and death in people taking the combination to people on calcium channel blockers who were prescribed a different antibiotic. They found that the risk of having one of those health outcomes within 30 days of starting the antibiotic “was doubled in people taking the clarithromycin and calcium channel blocker combination.”

The class of clarithromycin antibiotics include amlodipine (sold under the brand name Norvasc), nifedipine (Adalat), felodipine (Plendil), diltiazem (Cardizem) and verapamil (Isoptin). Clarithromycin is sold under the brand name Biaxin.

“Although the absolute increases in the risks were small, these outcomes have important clinical implications. Our results suggest that potentially hundreds of hospitalizations and deaths in our region may have been associated with this largely preventable drug-drug interaction. This burden on the health-care system, given the high costs of managing acute kidney injury, might have been avoided,” the authors stated in the study.

According to Garg, data from other parts of the world show that this unwise combination of medications is also prescribed elsewhere. Moreover, “the study provides high level evidence for health-care professionals and pharmacists that this combination should be avoided.”

The researchers published a study earlier this year showing that clarithromycin and another antibiotic, erythromycin, also interact in a similar manner with cholesterol-lowering statin drugs.

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