European journal of pain : EJP
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Randomized Controlled Trial
Clarithromycin, a potent inhibitor of CYP3A, greatly increases exposure to oral S-ketamine.
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.