Lovastatin and Clarithromycin: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Clarithromycin
Lovastatin
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
An increased lovastatin exposure and an increased risk of myopathy or rhabdomyolysis
Interaction Deep Dive
Lovastatin is a CYP3A4 substrate81. Clarithromycin is both a substrate and strong inhibitor of CYP3A4. Concomitant use of clarithromycin with HMG-CoA reductase inhibitors that are dependent on CYP3A4 metabolism such as lovastatin has resulted in increased statin plasma concentrations which may increase the risk of myopathy and rhabdomyolysis, and is contraindicated. If clarithromycin therapy is necessary, suspend lovastatin during the course of treatment or switch to a statin that is not dependent on CYP3A4 metabolism, such as fluvastatin 4567.
Why it happens (mechanism)
Inhibition of CYP3A4-mediated lovastatin metabolism by clarithromycin
Literature reports
1 report — tap to read
a) In a retrospective, population-based cohort study of adults older than 65 years taking a statin metabolized by CYP3A (atorvastatin, 73%; simvastatin, 24%; lovastatin, 3%), concomitant administration with clarithromycin (n=72,591) or erythromycin (n=3267) was associated a rate of hospitalization for rhabdomyolysis of 0.03% and a rate of hospitalization for acute kidney injury of 0.46%. Corresponding rates with concomitant administration of azithromycin (n=68,478) were 0.01% and 0.26%, respectively. The all-cause mortality rate was 0.7% in the clarithromycin/erythromycin group and 0.45% in the azithromycin group 3.
Common questions
Can I take Lovastatin and Clarithromycin together?
An increased lovastatin exposure and an increased risk of myopathy or rhabdomyolysis Always confirm with your pharmacist or prescriber before making any change.
How serious is the Lovastatin and Clarithromycin interaction?
It is rated contraindicated. These should generally not be used together.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Lovastatin or Clarithromycin need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (8)
- Product Information: ALTOPREV(R) oral extended-release tablets, lovastatin oral extended-release tablets. Covis Pharma (per FDA), King of Prussia, PA, 2024. DailyMed
- Product Information: MEVACOR(R) oral tablets, lovastatin oral tablets. Merck Sharp & Dohme Corp. (per FDA), Whitehouse Station, NJ, 2014. DailyMed
- Patel AM, Shariff S, Bailey DG, et al: Statin toxicity from macrolide antibiotic coprescription: a population-based cohort study. Ann Intern Med 2013; 158(12):869-876. DOI
- Product Information: BIAXIN(R) XL Filmtab(R) oral extended-release tablets, clarithromycin oral extended-release tablets. AbbVie Inc (per FDA), North Chicago, IL, 2018. DailyMed
- Product Information: BIAXIN(R) Filmtab(R) oral tablets, clarithromycin oral tablets. AbbVie Inc. (per FDA), North Chicago, IL, 2015. DailyMed
- Product Information: BIAXIN(R) Granules oral suspension, clarithromycin oral suspension. AbbVie Inc. (per FDA), North Chicago, IL, 2015. DailyMed
- Product Information: VOQUEZNA(TM) TRIPLE PAK(TM) oral kit, vonoprazan oral tablets, amoxicillin oral capsules, clarithromycin oral tablets kit. Phathom Pharmaceuticals (per FDA), Buffalo Grove, IL, 2023. DailyMed
- Product Information: MEVACOR(R) oral tablets, lovastatin oral tablets. Merck Sharp & Dohme Corp, Whitehouse Station, NJ, 2010. DailyMed
Keep reading about Clarithromycin
Keep reading about Lovastatin
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
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