Another drug class of note in this category is the 3-hydroxy-3-methylglutaryl-coenzyme A (HMG CoA) reductase inhibitors.
High serum concentrations of some of these agents are strongly linked to the development of rhabdomyolysis. Adding a CYP3A4 inhibitor to a drug regimen that includes certain HMG CoA reductase inhibitors greatly increases the patient’s risk of developing rhabdomyolysis. One advantage of recognizing this drug interaction has been the subsequent studies conducted to identify which agents can be used safely in multidrug combinations. Research focusing on CYP3A4 inhibitors and HMG CoA reductase inhibitors has found that pravastatin and fluvastatin can be coadministered with itraconazole, a potent CYP3A4 inhibitor, without significant changes in maximum serum concentrations(6, 7).