Cardiovascular drugs: fibrate and statin interaction: practice question

A Pharmacology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pharmacology · Cardiovascular drugs: fibrate and statin interaction

Sample item

A man on simvastatin adds a fibrate for high triglycerides. Two weeks later he has diffuse myalgia, dark urine and a creatine kinase twelve times normal. Which fibrate was most likely added?

AGemfibrozilBClofibrateCBezafibrateDFenofibrate

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Gemfibrozil

Gemfibrozil inhibits glucuronidation and hepatic uptake of statins, raising statin levels and the risk of myopathy and rhabdomyolysis. Fenofibrate does not share this interaction and is the fibrate preferred when combined with a statin.

Option by option

A. Gemfibrozil (correct)
Correct. It inhibits statin glucuronidation and uptake and sharply raises the risk of rhabdomyolysis.
B. Clofibrate
Clofibrate is an obsolete fibrate that does not carry this specific interaction.
C. Bezafibrate
Bezafibrate has a far smaller interaction with statin clearance.
D. Fenofibrate
Fenofibrate has little effect on statin metabolism and is the safer fibrate with a statin.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is A, Gemfibrozil. Gemfibrozil inhibits glucuronidation and hepatic uptake of statins, raising statin levels and the risk of myopathy and rhabdomyolysis.

Why is "Clofibrate" not the answer?

Clofibrate is an obsolete fibrate that does not carry this specific interaction.

Why is "Bezafibrate" not the answer?

Bezafibrate has a far smaller interaction with statin clearance.

Why is "Fenofibrate" not the answer?

Fenofibrate has little effect on statin metabolism and is the safer fibrate with a statin.

What concept does this question test?

It tests Cardiovascular drugs: fibrate and statin interaction in Pharmacology. Fenofibrate does not share this interaction and is the fibrate preferred when combined with a statin.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Cardiovascular drugs: fibrate and statin interaction?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.