CriticalMacrolide antibiotic×HMG-CoA reductase inhibitor (statin)
Updated · Methodology
Mechanism
Clarithromycin inhibits CYP3A4 – lovastatin (sensitive substrate) rises 8-fold. Rhabdomyolysis risk.
Symptoms
Myalgia, weakness, dark urine, rising CK within 5-10 days.
Management
Combination contraindicated. Switch lovastatin to pravastatin or rosuvastatin during the course.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.
Summary of a multi-drug list →
Medicine list: everything you take in one place →
Sources
- FDA: Lovastatin tablet (Bluepoint Laboratories) – Prescribing Information – CYP3A4 contraindications (2014)– FDA Mevacor label, Contraindications §4; DailyMed setid 7b86160d-74a9-4774-b5b3-5641e686991f
- FDA: Clarithromycin tablet (Solaris Pharma Corporation) – Prescribing Information – CYP3A4 inhibition (2018)– FDA Biaxin label, Drug Interactions §7; DailyMed setid 4d42821d-ce7a-7d64-e063-6294a90a0875
- FDA: Lovastatin tablets – Prescribing Information (2014)
- AEMPS: Ficha técnica: Lovastatina (nº registro 64438), sección 4.3 (2023)– AEMPS, CIMA, nº registro 64438, revisión 07/2023, sección 4.3
- AEMPS: Ficha técnica: Claritromicina (nº registro 75638), sección 4.3 (2025)– AEMPS, CIMA, nº registro 75638, revisión 03/2025, sección 4.3