Minor
Established
Deskripsi
Fluconazole has minimal effect on pravastatin exposure because pravastatin is not significantly metabolised by CYP enzymes; the interaction is pharmacokinetically unimportant in most patients.
Mekanisme
Unlike most statins, pravastatin relies on renal and biliary excretion rather than CYP3A4 metabolism; fluconazole's CYP inhibition does not substantially affect pravastatin clearance.
Signifikansi Klinis
Pharmacokinetic studies confirm no clinically significant increase in pravastatin AUC with fluconazole; no cases of myopathy attributable to this combination have been reported.
Penatalaksanaan
No dose adjustment required; this combination is generally preferred over other statin-azole combinations.