Minor
Clarithromycin × Rosuvastatin
Macrolide antibiotic×HMG-CoA reductase inhibitors (statins)
Mechanism
Rosuvastatin is excreted mainly unchanged and minimally metabolised by CYP. Clarithromycin (a strong CYP3A4 inhibitor) does not significantly change rosuvastatin AUC.
Symptoms
The combination usually causes no specific symptoms. Each drug's individual side effects remain.
Management
No dose adjustment needed. Rosuvastatin is the preferred statin when a short clarithromycin or erythromycin course is needed. Atorvastatin and simvastatin should not be combined with clarithromycin — rhabdomyolysis risk.