US Pharm. 2015;40(1):10.

London, Ontario—The combination of clarithromycin with certain statins increases the risk of adverse events, which in older patients may necessitate hospitalization. Researchers at Western University examined data on more than 104,000 patients aged 66 years who took rosuvastatin, pravastatin, or fluvastatin and also had a prescription for clarithromycin or azithromycin. Previous studies indicated that these statins are safer to take with clarithromycin because they are metabolized differently, but in this analysis, coprescription of clarithromycin and a statin was associated with a modest increase in the number of deaths and hospital admissions for acute kidney injury or high potassium levels. Researchers believe that these adverse events may reflect statin toxicity in older adults and that other metabolic pathways may be responsible.

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