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Clarithromycin, a potent inhibitor of CYP3A, greatly increases exposure to oral S-ketamine
European Journal of Pain, 11/10/09
Hagelberg NM et al. – Oral ketamine is used as an adjuvant in the treatment of refractory neuropathic and cancer–related pain. Drug interactions may alter the analgesic or other effects of ketamine...Clarithromycin strongly increases plasma concentrations of oral S–ketamine probably by inhibiting its CYP3A–mediated N–demethylation. This increase is reflected as modest changes in behavioral effects of oral S–ketamine.
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