Ketoconazole (systemic) vs HMG-CoA Reductase Inhibitors

Interacting Drugs
Ketoconazole (systemic)
vs
HMG-CoA Reductase Inhibitors
Security Level
Moderate, Consider therapy modification
Mechanism
HMG-CoA Reductase Inhibitors: Antifungal Agents (Azole Derivatives, Systemic) may decrease the metabolism of HMG-CoA Reductase Inhibitors.
Management
Consider use of HMG-CoA reductase inhibitors posing the least rhabdomyolysis risk (e.g. fluva- or pravastatin), and monitor for signs/symptoms of rhabdomyolysis. Do not use keto- or itraconazole with lova- or simvastatin, or posaconazole with simvastatin. Exceptions: Fluvastatin; Pitavastatin; Rosuvastatin.

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