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Statin and clarithromycin — GPhC CRA MCQ

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ModerateCardiovascular TherapeuticsStatin and clarithromycinGPhC CRA

A 58-year-old man taking simvastatin 40 mg at night is prescribed clarithromycin 500 mg twice daily for pneumonia. He asks whether to continue all regular medicines. What is the most important interaction to flag?

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Correct answer: E — Flag increased simvastatin exposure and seek advice on withholding or changing therapy

Clarithromycin inhibits CYP3A4 and can markedly increase simvastatin concentrations, increasing myopathy risk. Simvastatin is commonly withheld during clarithromycin or an alternative antibiotic/statin strategy considered. A short course does not remove the interaction risk.

Reference: BNF