Drug interactions
Erythromycin base + Simvastatin
Severity: Contraindicated
Erythromycin base and Simvastatin: contraindicated interaction.
Last updated Sources: US FDA label
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.
Summary
Erythromycin increases simvastatin exposure and has been linked to rhabdomyolysis with this combination. The labeling contraindicates the pair.
What this interaction means in plain words
Erythromycin base and Simvastatin are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Why it happens
Erythromycin inhibits intestinal and hepatic CYP3A4, decreasing simvastatin metabolism.
What to do
Avoid the combination; withhold simvastatin during erythromycin therapy or use an alternative antibiotic such as azithromycin, which has less CYP3A4 effect.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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References
Other interactions of Simvastatin
- Atazanavir + Simvastatin Contraindicated
- Clarithromycin + Simvastatin Contraindicated
- Cobicistat + Simvastatin Contraindicated
- Cyclosporin + Simvastatin Contraindicated
- Danazol + Simvastatin Contraindicated
- Darunavir + Simvastatin Contraindicated
Frequently asked questions
Can I take Erythromycin base with Simvastatin?
MediHelp rates the interaction as contraindicated. Erythromycin base and Simvastatin are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Erythromycin increases simvastatin exposure and has been linked to rhabdomyolysis with this combination. The labeling contraindicates the pair.
How serious is the interaction between Erythromycin base and Simvastatin?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination; withhold simvastatin during erythromycin therapy or use an alternative antibiotic such as azithromycin, which has less CYP3A4 effect.
What other medicines interact with Simvastatin?
MediHelp also lists interactions of Simvastatin with, for example, Atazanavir, Clarithromycin, Cobicistat. The full list is on the Simvastatin page.
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