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Interações medicamentosas

Clarithromycin + Simvastatin

Gravidade: Contraindicada

Clarithromycin and Simvastatin: contraindicated interaction.

Última atualização Fontes: US FDA label

Para profissionais de saúde — apenas referência. Esta página é um resumo breve, não é aconselhamento médico nem substitui a bula oficial ou o julgamento clínico. Verifique sempre antes de prescrever ou dispensar.

O conteúdo clínico desta página está disponível apenas em inglês.

Resumo

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.

O que esta interação significa em palavras simples

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.

Nível de evidência: High

Por que acontece

Clarithromycin is a strong CYP3A4 inhibitor (and P-gp inhibitor), reducing the first-pass and systemic metabolism of simvastatin and its active acid.

O que fazer

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.

O que perguntar ao farmacêutico

  • 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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Referências

Perguntas frequentes

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.

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