藥物交互作用
Clarithromycin + Simvastatin
嚴重程度: 禁忌併用
Clarithromycin and Simvastatin: contraindicated interaction.
最後更新 來源: US FDA label
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摘要
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.
用白話說明這項交互作用的意義
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.
為什麼會發生
Clarithromycin is a strong CYP3A4 inhibitor (and P-gp inhibitor), reducing the first-pass and systemic metabolism of simvastatin and its active acid.
處置方式
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.
可向藥師詢問的問題
- 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?
參考資料
Simvastatin 的其他交互作用
Clarithromycin 的其他交互作用
常見問題
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.
在 MediHelp App 中取得完整藥品專論、劑量資訊與交互作用檢查
在 MediHelp App 中開啟完整參考資料、檢查多種藥物間的交互作用,並使用劑量工具。