Critical
Lovastatin × Voriconazole
HMG-CoA reductase inhibitor (statin)×Triazole derivatives, systemic antifungals
Mechanism
Strong CYP3A4 inhibitor. Lovastatin rises 10+ fold.
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: Vfend (voriconazole) prescribing information – CYP3A4 inhibitor, statin/immunosuppressant interactions (2020)– FDA Vfend label, Drug Interactions §7 – tacrolimus, cyclosporine, sirolimus, statins
- FDA: Mevacor (lovastatin) prescribing information – CYP3A4 contraindications (2014)– FDA Mevacor label, Contraindications §4
- FDA: Mevacor (lovastatin) prescribing information (2014)