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Does Clarithromycin Interact with Simvastatin?

Clarithromycin and Simvastatin have a contraindicated drug interaction according to U.S. FDA drug labeling data. Gastroprokinetic Agents: Cisapride Contraindicated Cisapride : [See Contraindications (4.2) ] Lipid-lowering agents: Lomitapide Lovastatin Simvastatin Atorvastatin Pravastatin Fluvastatin Contraindicated Use With Caution No Dose Adjustment Lomitapide, Lovastatin, Simvastatin: Clarithromycin may increase the exposure of these drugs by inhibition of CYP3A metabolism, thereby increasing the risk of toxicities from these drugs [see Contraindications (4.5) and Warnings and Precautions (5.4) ] Atorvastatin, Pravastatin, Fluvastatin: [See Warnings and Precautions (5.4) ] Hypoglycemic Agents: Nateglinide Pioglitazone Repaglinide Rosiglitazone Insulin Use With Caution Nateglinide, Pioglitazone, Repaglinide, Rosiglitazone : [See Warnings and Precautions (5.4) and Adverse Reactions (6.2) ] Insulin : [See Warnings and Precautions (5.4) and Adverse Reactions (6.2) ] Immunosuppressants: Cyclosporine Tacrolimus Use With Caution Cyclosporine : There have been spontaneous or published reports of CYP3A based interactions of clarithromycin with cyclosporine. Patients taking both medications should consult their healthcare provider before starting, stopping, or changing the dosage of either drug. This information is based on official FDA drug labeling sourced from OpenFDA and the NIH National Library of Medicine.

Severity
Contraindicated
Clarithromycin Class
Macrolide Antimicrobial
Simvastatin Class
HMG-CoA Reductase Inhibitor
Management
Do not take together
Data Source
U.S. FDA via OpenFDA

What To Tell Your Doctor or Pharmacist

If you are taking Clarithromycin and your doctor is considering prescribing Simvastatin (or vice versa), make sure to:

  • Inform your doctor and pharmacist of all current medications, including over-the-counter drugs and supplements
  • Ask whether the benefits of combining these medications outweigh the risks for your specific situation
  • Ask what symptoms to watch for that would indicate the interaction is causing problems
  • Ask about alternative medications that do not interact with your current regimen
  • Ask how frequently you should be monitored while these are co-prescribed
  • Never stop or change either medication without first consulting your healthcare provider
💊 Clarithromycin+💊 Simvastatin

Severity & Interaction Details

⛔
contraindicated
Avoid this combination
FDA labeling lists this pair as contraindicated. The risk outweighs the benefit in nearly all cases.
Severity scale
MinorContra
On record
Yes
Drug A class
Macrolide Antimicrobial
Drug B class
HMG-CoA Reductase Inhibitor
Source
FDA drug label - clarithromycin

What this means in plain English

Gastroprokinetic Agents: Cisapride Contraindicated Cisapride : [See Contraindications (4.2) ] Lipid-lowering agents: Lomitapide Lovastatin Simvastatin Atorvastatin Pravastatin Fluvastatin Contraindicated Use With Caution No Dose Adjustment Lomitapide, Lovastatin, Simvastatin: Clarithromycin may increase the exposure of these drugs by inhibition of CYP3A metabolism, thereby increasing the risk of toxicities from these drugs [see Contraindications (4.5) and Warnings and Precautions (5.4) ] Atorvastatin, Pravastatin, Fluvastatin: [See Warnings and Precautions (5.4) ] Hypoglycemic Agents: Nateglinide Pioglitazone Repaglinide Rosiglitazone Insulin Use With Caution Nateglinide, Pioglitazone, Repaglinide, Rosiglitazone : [See Warnings and Precautions (5.4) and Adverse Reactions (6.2) ] Insulin : [See Warnings and Precautions (5.4) and Adverse Reactions (6.2) ] Immunosuppressants: Cyclosporine Tacrolimus Use With Caution Cyclosporine : There have been spontaneous or published reports of CYP3A based interactions of clarithromycin with cyclosporine.

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Data sourced from U.S. FDA drug labeling via openFDA and the NIH National Library of Medicine. For informational purposes only. Always consult your pharmacist or physician.