Acute sore throat — GPhC CRA MCQ
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Correct answer: C — Withhold eliglustat because this dual enzyme-inhibitor combination is contraindicated
Explanation lettering: E = shown as A · D = shown as B · B = shown as C · C = shown as D · A = shown as E
A is wrong: the combination is not converted into an acceptable regimen by a routine once-daily reduction. B is correct: paroxetine provides strong CYP2D6 inhibition and clarithromycin strong CYP3A inhibition; in a CYP2D6 extensive metaboliser, combined inhibition is contraindicated because eliglustat exposure may rise dramatically. C ignores CYP2D6/CYP3A metabolism. D cannot prevent enzyme inhibition. E reverses the pharmacokinetic effect.
Reference: Cerdelga eliglustat SmPC. https://www.medicines.org.uk/emc/product/2615/smpc