相互作用
Clarithromycin + Simvastatin
重症度: 併用禁忌
Clarithromycin and Simvastatin: contraindicated interaction.
最終更新日 出典: US FDA label
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概要
Clarithromycin substantially increases simvastatin acid exposure and raises the risk of myopathy and rhabdomyolysis, which may lead to acute kidney injury. The combination is contraindicated in simvastatin labeling. Older patients, those with renal impairment or on higher simvastatin doses are at greatest risk.
この相互作用をわかりやすく説明すると
Clarithromycin 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.
Clarithromycin belongs to Anti Bacterial; Simvastatin belongs to Cardiovascular.
なぜ起こるのか
Clarithromycin is a strong CYP3A4 inhibitor (and P-gp inhibitor), reducing the first-pass and systemic metabolism of simvastatin and its active acid.
対処法
Do not use together; suspend simvastatin for the duration of clarithromycin therapy, or use an alternative antibiotic such as azithromycin. For short courses, temporary interruption is usually preferred; pravastatin or rosuvastatin are options if statin continuation is essential.
薬剤師に尋ねること
- 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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アカウントを作成してPro+トライアルを始めると、ClarithromycinとSimvastatinの臨床対応の詳細なアドバイス、追加の注記、エビデンスの詳細、処方全体を対象とした相互作用チェッカーを利用できます。
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
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参考文献
Simvastatinのその他の相互作用
Clarithromycinのその他の相互作用
よくある質問
Can I take Clarithromycin with Simvastatin?
MediHelp rates the interaction as contraindicated. Clarithromycin 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. Clarithromycin substantially increases simvastatin acid exposure and raises the risk of myopathy and rhabdomyolysis, which may lead to acute kidney injury. The combination is contraindicated in simvastatin labeling. Older patients, those with renal impairment or on higher simvastatin doses are at greatest risk.
How serious is the interaction between Clarithromycin 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: Do not use together; suspend simvastatin for the duration of clarithromycin therapy, or use an alternative antibiotic such as azithromycin. For short courses, temporary interruption is usually preferred; pravastatin or rosuvastatin are options if statin continuation is essential.
What other medicines interact with Simvastatin?
MediHelp also lists interactions of Simvastatin with, for example, Atazanavir, Cobicistat, Cyclosporine. The full list is on the Simvastatin page.
完全なモノグラフ、用量、相互作用チェッカーはMediHelpアプリで
MediHelpアプリで、完全なリファレンスを開き、複数薬剤の相互作用をチェックし、用量ツールを利用できます。
