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H. pylori eradication interaction — GPhC CRA MCQ

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ModerateGastro-intestinal TherapeuticsH. pylori eradication interactionGPhC CRA

A 63-year-old man taking simvastatin 40 mg nightly is prescribed clarithromycin, amoxicillin and lansoprazole for H. pylori eradication. He asks if he can continue every regular medicine. What is the most important interaction to flag?

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Correct answer: E — Clarithromycin increases simvastatin exposure and myopathy risk

Clarithromycin strongly inhibits CYP3A4 and can significantly increase simvastatin levels. This increases the risk of myopathy and rhabdomyolysis. The prescriber should be contacted to hold or change the statin or select an alternative regimen where appropriate.

Reference: BNF; NICE CKS