Drug interactions
clarithromycin + rosuvastatin
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
Clarithromycin may increase rosuvastatin concentrations, raising risk of myopathy/rhabdomyolysis.
Mechanism of action
Inhibition of hepatic drug transporters (OATP1B1/1B3 and possibly BCRP) by clarithromycin, increasing rosuvastatin exposure; CYP3A4 inhibition is less relevant for rosuvastatin.
Clinical management
Prefer an alternative macrolide (e.g., azithromycin) or temporarily withhold/limit rosuvastatin during clarithromycin therapy in high‑risk patients. If coadministered, use the lowest effective rosuvastatin dose and monitor closely for muscle symptoms; check CK and renal function if symptomatic.
Drug reference
References
- Clarithromycin: Drug interactions monograph — Lexicomp
- Rosuvastatin (Crestor) Prescribing Information — FDA Label
- Clarithromycin: Drug information (including drug interactions) — UpToDate
Frequently asked questions
Can I take clarithromycin with rosuvastatin?
The interaction is rated: Moderate. Clarithromycin may increase rosuvastatin concentrations, raising risk of myopathy/rhabdomyolysis.
How serious is the interaction between clarithromycin and rosuvastatin?
The interaction is rated: Moderate. Evidence level: Moderate.
How is the interaction between clarithromycin and rosuvastatin managed?
Prefer an alternative macrolide (e.g., azithromycin) or temporarily withhold/limit rosuvastatin during clarithromycin therapy in high‑risk patients. If coadministered, use the lowest effective rosuvastatin dose and monitor closely for muscle symptoms; check CK and renal function if symptomatic.
Why do clarithromycin and rosuvastatin interact?
Inhibition of hepatic drug transporters (OATP1B1/1B3 and possibly BCRP) by clarithromycin, increasing rosuvastatin exposure; CYP3A4 inhibition is less relevant for rosuvastatin.
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