Лекарственные взаимодействия
Clarithromycin + Simvastatin
Тяжесть: Противопоказано
Clarithromycin and Simvastatin: contraindicated interaction.
Последнее обновление Источники: US FDA label
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Кратко
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.
Что означает это взаимодействие простыми словами
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.
Почему это происходит
Clarithromycin is a strong CYP3A4 inhibitor (and P-gp inhibitor), reducing the first-pass and systemic metabolism of simvastatin and its active acid.
Что делать
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.
О чём спросить фармацевта
- 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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Источники
Другие взаимодействия Simvastatin
- Atazanavir + Simvastatin Противопоказано
- Cobicistat + Simvastatin Противопоказано
- Cyclosporine + Simvastatin Противопоказано
- Cyclosporin + Simvastatin Противопоказано
- Danazol + Simvastatin Противопоказано
- Darunavir + Simvastatin Противопоказано
Другие взаимодействия Clarithromycin
- Astemizole + Clarithromycin Противопоказано
- Avanafil + Clarithromycin Противопоказано
- Cisapride + Clarithromycin Противопоказано
- Clarithromycin + Colchicine Противопоказано
- Clarithromycin + Conivaptan Противопоказано
- Clarithromycin + Dihydroergotamine Противопоказано
Частые вопросы
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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