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Macrolide and simvastatin — GPhC CRA MCQ

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HardDrug InteractionsMacrolide and simvastatinGPhC CRA

A 72-year-old woman taking simvastatin 40 mg daily is prescribed clarithromycin 500 mg twice daily for community-acquired pneumonia. She has CKD stage 3 and previously had statin myalgia. What is the most important interaction to flag?

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Correct answer: C — Clarithromycin with simvastatin increases myopathy risk

Clarithromycin inhibits metabolism of simvastatin and can increase the risk of myopathy and rhabdomyolysis. The patient's CKD and previous myalgia raise concern further. The pharmacist should contact the prescriber about holding simvastatin or choosing a suitable alternative antibiotic.

Reference: BNF