Critical
Itraconazole × Lovastatin
Antifungal, triazole×HMG-CoA reductase inhibitor (statin)
Mechanism
Strong CYP3A4 inhibitor – lovastatin rises 20+ fold. FDA contraindication.
Symptoms
Myalgia, weakness, dark urine, rising CK within 5-10 days.
Management
Combination contraindicated.
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.
Sources
- FDA: Mevacor (lovastatin) prescribing information – CYP3A4 contraindications (2014)– FDA Mevacor label, Contraindications §4
- FDA: Sporanox (itraconazole) prescribing information – CYP3A4 inhibition contraindications (2020)– FDA Sporanox label, Contraindications §4 and Drug Interactions §7
- FDA: Mevacor (lovastatin) prescribing information (2014)