STOP — Contraindicated
FDA contraindication. Same mechanism as simvastatin. Suspend lovastatin during clarithromycin or use alternative antibiotic.
Evidence level: STRONG
Clarithromycin with lovastatin (Mevacor) can cause dangerous muscle breakdown (rhabdomyolysis) by causing lovastatin to build up to toxic levels in your blood.
Clarithromycin (strong CYP3A4 inhibitor) dramatically increases lovastatin levels. Lovastatin is extensively metabolized by CYP3A4. FDA lovastatin label contraindicates strong CYP3A4 inhibitors.
Stop lovastatin while taking clarithromycin. A few days without your cholesterol medication is safer than risking severe muscle damage.
Some antibiotics (erythromycin, clarithromycin) strongly inhibit CYP3A4 and can dramatically increase statin levels, raising rhabdomyolysis risk. Take Lovastatin in the evening as usual. Your prescriber may temporarily pause or reduce the statin during short antibiotic courses.
Higher risk for: those with liver impairment, genetic CYP enzyme variations (poor or ultra-rapid metabolizers), elderly, those on multiple CYP3A4 inhibitors, high-dose statin therapy, or history of myopathy.
Severe muscle pain, dark colored urine, weakness, nausea, kidney pain
Request temporary statin holiday. Ask about azithromycin instead of clarithromycin.
Statin interactions often involve liver enzyme competition. Ask your doctor about alternative statins (rosuvastatin and pravastatin have fewer CYP interactions) or spacing doses 12 hours apart. CoQ10 supplementation may help with statin-related muscle discomfort.
Clarithromycin with lovastatin (Mevacor) can cause dangerous muscle breakdown (rhabdomyolysis) by causing lovastatin to build up to toxic levels in your blood.
Some antibiotics (erythromycin, clarithromycin) strongly inhibit CYP3A4 and can dramatically increase statin levels, raising rhabdomyolysis risk. Take Lovastatin in the evening as usual. Your prescriber may temporarily pause or reduce the statin during short antibiotic courses.
Severe muscle pain, dark colored urine, weakness, nausea, kidney pain
Statin interactions often involve liver enzyme competition. Ask your doctor about alternative statins (rosuvastatin and pravastatin have fewer CYP interactions) or spacing doses 12 hours apart. CoQ10 supplementation may help with statin-related muscle discomfort.
Request temporary statin holiday. Ask about azithromycin instead of clarithromycin.
Or browse the full interaction database (121,000+ pairs).