The Annals of Internal Medicine report of a study of more than 144,000 statin users over the age of 65 which evaluated patients who received clarithromycin or erythromycin and compared them with patients taking azithromycin. The researchers found that those patients who took erythromycin and clarithromycin with statins experienced a 26 percent increase in absolute risk for developing kidney damage compared with patients who took azithromycin with statins. The mechanism behind this interaction involves inhibition of the chytochrome P450 isoenzyme 3A4, which increases the level of statin medications in the body.
- Statin Toxicity From Macrolide Antibiotic Coprescription:A Population-Based Cohort Study Ann Intern Med. 2013;158(12):869-876.