Drug interactions
azithromycin + statin
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Overview
Rare myopathy/rhabdomyolysis reported with concomitant use despite minimal CYP3A4 effect by azithromycin; risk may be higher with simvastatin/atorvastatin or in predisposed patients.
Mechanism of action
Unknown; azithromycin is not a significant CYP3A4 inhibitor. Proposed mechanisms include transporter effects and/or additive myotoxicity.
Clinical management
Generally continue with caution. Counsel patients to report muscle pain/weakness or dark urine; check CK and renal function if symptoms. Consider temporarily holding the statin during the short azithromycin course in high-risk patients.
Drug reference
References
- Managing interactions between macrolides and statins — SPS
- Azithromycin: Drug Interactions — Lexicomp
- Azithromycin and simvastatin Interactions — Drugs.com
Frequently asked questions
Can I take azithromycin with statin?
The interaction is rated: Moderate. Rare myopathy/rhabdomyolysis reported with concomitant use despite minimal CYP3A4 effect by azithromycin; risk may be higher with simvastatin/atorvastatin or in predisposed patients.
How serious is the interaction between azithromycin and statin?
The interaction is rated: Moderate. Evidence level: Moderate.
How is the interaction between azithromycin and statin managed?
Generally continue with caution. Counsel patients to report muscle pain/weakness or dark urine; check CK and renal function if symptoms. Consider temporarily holding the statin during the short azithromycin course in high-risk patients.
Why do azithromycin and statin interact?
Unknown; azithromycin is not a significant CYP3A4 inhibitor. Proposed mechanisms include transporter effects and/or additive myotoxicity.
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