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Fluconazole interaction — GPhC CRA MCQ

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ModerateInfectionsFluconazole interactionGPhC CRA

A woman asks to buy fluconazole 150 mg for vaginal candidiasis. Her medication history includes simvastatin 40 mg at night, amlodipine, salbutamol and lansoprazole. She has used topical clotrimazole before. What is the most important interaction to flag?

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Correct answer: A — Fluconazole may increase simvastatin exposure and myopathy risk

Fluconazole inhibits CYP enzymes and can increase exposure to some statins, including simvastatin, increasing the risk of myopathy and rhabdomyolysis. The pharmacist should assess whether an oral azole is suitable and consider topical treatment or prescriber advice. Salbutamol and lansoprazole are not the key concern in this scenario. The previous use of topical clotrimazole does not itself create a significant interaction.

Reference: BNF