STOP — Contraindicated
FDA contraindication. Suspend simvastatin during erythromycin course or use alternative antibiotic.
Evidence level: STRONG
Erythromycin blocks the enzyme that breaks down simvastatin (Zocor), causing dangerous buildup that can destroy muscle tissue and damage kidneys.
Erythromycin is a strong CYP3A4 inhibitor. Simvastatin is a CYP3A4 substrate. Co-administration significantly increases simvastatin exposure and rhabdomyolysis risk. FDA simvastatin label contraindicates this.
Stop simvastatin temporarily while taking erythromycin. Contact your doctor for guidance. Do not restart simvastatin until erythromycin course is complete.
Some antibiotics (erythromycin, clarithromycin) strongly inhibit CYP3A4 and can dramatically increase statin levels, raising rhabdomyolysis risk. Take Simvastatin 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 or weakness, dark urine, fever, nausea, decreased urination
Discuss temporary statin holiday or alternative antibiotic. Seek emergency care if muscle symptoms develop.
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.
Erythromycin blocks the enzyme that breaks down simvastatin (Zocor), causing dangerous buildup that can destroy muscle tissue and damage kidneys.
Some antibiotics (erythromycin, clarithromycin) strongly inhibit CYP3A4 and can dramatically increase statin levels, raising rhabdomyolysis risk. Take Simvastatin in the evening as usual. Your prescriber may temporarily pause or reduce the statin during short antibiotic courses.
Severe muscle pain or weakness, dark urine, fever, nausea, decreased urination
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.
Discuss temporary statin holiday or alternative antibiotic. Seek emergency care if muscle symptoms develop.
Or browse the full interaction database (121,000+ pairs).