Simvastatin + clarithromycin
- Simvastatin is a sensitive CYP3A victim
- Clarithromycin strongly inhibits CYP3A
- active statin exposure may rise >10×
- Myopathy/rhabdomyolysis risk rises
- Combination is contraindicated
- Hold simvastatin or use another antibiotic
Interaction at a glance
- Clarithromycin strongly inhibits CYP3A
- active statin exposure may rise >10×
- Combination is contraindicated
Management
- Simvastatin is a sensitive CYP3A victim
- Combination is contraindicated
Magnitude / time course
- Clarithromycin strongly inhibits CYP3A
- active statin exposure may rise >10×
Clinical consequence
- Myopathy/rhabdomyolysis risk rises
Mechanism
- Hold simvastatin or use another antibiotic
Self-check
- Should Simvastatin + clarithromycin be combined?
No—this combination is contraindicated.
- In Simvastatin + clarithromycin, what is the approximate magnitude of the exposure change?
active statin exposure may rise >10×
Drugs in this interaction (2)
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