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Simvastatin and macrolide management — GPhC CRA MCQ

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ModerateCardiovascular TherapeuticsSimvastatin and macrolide managementGPhC CRA

A 70-year-old woman taking simvastatin 40 mg at night is prescribed clarithromycin for a chest infection. She asks whether she should take both medicines together. What is the most appropriate alternative?

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Correct answer: E — Temporarily withhold simvastatin or ask prescriber to use a non-interacting antibiotic

Clarithromycin inhibits CYP3A4 and can markedly increase simvastatin concentrations. The safest practical options are to withhold simvastatin during the short antibiotic course or ask the prescriber about a non-interacting antibiotic. Dose separation does not prevent the interaction.

Reference: BNF