“ The population impact of this preventable drug-drug interaction can be considered in the context of the high frequency of
If clarithromycin is necessary, we recommend (a) avoiding co‐administration with simvastatin, lovastatin or atorvastatin; (b) withholding or dose‐reducing pitavastatin; (c)
Based on mechanistic/clinical studies involving clarithromycin or the related macrolide erythromycin (both strong inhibitors of CYP3A4 and of hepatic statin uptake
Drugs that inhibit CYP3A4 enzyme
The concomitant administration of macrolide antibiotics and
The study design comprised of two phases, used at interval of one week
For a complete list of possible drug interactions of all statins, see the electronic Medicines Compendium (eMC) or the British National Formulary (BNF)
KEYWORDS case report, clarithromycin, drug‐drug interaction, MiniReview, statins The most common adverse effects of clarithromycin include If clarithromycin treatment cannot be avoided, stop treatment with simvastatin during the course of the treatment or prescribe the lowest starting dose of atorvastatin (that is 10 mg) and do not exceed 20 mg atorvastatin daily
001) increased the AUC (and C max) of all 3 statins, most markedly simvastatin (∼10-fold increase in AUC) and simvastatin acid (12-fold), followed by atorvastatin (greater than fourfold) and then pravastatin (almost twofold)
Simvastatin interaction with clarithromycin and amiodarone causing myositis
Rhabdomyolysis is a serious condition that can result from muscle injury due to various causes, including drug interactions
The woman presented with diffuse muscle weakness and myalgia predominantly involving her legs and back
It has previously been shown to cause rhabdomyolysis in patients taking simvastatin
However, this was not the situation with our two patients
Clarithromycin Nelfinavir: Ranolazine: Other CYP3A4 inhibitors: Effect of simvastatin-amiodarone drug interaction alert on appropriate prescribing
Takahashi H, Echizen H
Simulated simvastatin and simvastatin hydroxy acid concentrations obtained from the final model produced a good fit to the dataset from a literature
Background: Simvastatin is a HMG-CoA reductase Inhibitor and a substrate of CYP3A4