Macrolide and Statin: Drug Interaction Guide

Quick answer: This is a major interaction — avoid combining Macrolide and Statin unless specifically directed by your doctor.

Interaction severity: Major — avoid combination

How Macrolide interacts with Statin

Macrolides (especially clarithromycin and erythromycin) inhibit CYP3A4 metabolism of simvastatin, lovastatin, and atorvastatin, raising plasma levels and rhabdomyolysis risk.

What you should do

Hold the statin during the macrolide course, or substitute azithromycin (minimal CYP3A4 effect) for the antibiotic and pravastatin or rosuvastatin for the statin.

Key facts

Severity

Major — avoid combination

Mechanism

Macrolides (especially clarithromycin and erythromycin) inhibit CYP3A4 metabolism of simvastatin, lovastatin, and atorva...

Action

Hold the statin during the macrolide course, or substitute azithromycin (minimal CYP3A4 effect) for the antibiotic and p...

Important medical disclaimer: This page provides educational information about drug interactions for general reference. It is not a substitute for professional medical advice, diagnosis, or treatment. Always discuss your specific medications with a qualified healthcare provider before starting, stopping, or changing any treatment. About our editorial team.

Frequently asked questions

Can I take Macrolide and Statin together?

No — this combination should generally be avoided. Hold the statin during the macrolide course, or substitute azithromycin (minimal CYP3A4 effect) for the antibiotic and pravastatin or rosuvastatin for the statin.

What is the severity of this interaction?

The interaction between Macrolide and Statin is classified as Major — avoid combination. Macrolides (especially clarithromycin and erythromycin) inhibit CYP3A4 metabolism of simvastatin, lovastatin, and atorvastatin, raising plasma levels and rhabdomyolysis risk.

What should I do if I'm prescribed both?

Hold the statin during the macrolide course, or substitute azithromycin (minimal CYP3A4 effect) for the antibiotic and pravastatin or rosuvastatin for the statin. Always consult your prescribing clinician — do not stop or change medications without medical guidance.

Last reviewed: by iMedic Medical Editorial Team. Our editorial process.