Concomitant use of potent CYP3A4 inhibitors such as clarithromycin, HIV protease inhibitors, and cyclosporine are contraindicated in patients taking Simvastatin (known and sold under the brand name Zocor® among many others) and other statins metabolized by the CYP3A4 such as Atorvastatin and Lovastatin. This may cause Simvastatin blood concentration to increase and augment the risk of developing muscle damage. Fluvastatin is metabolized by the CYP2C9 so that not makes its concentration increase. Whereas Pitavastatin, Rosuvastatin, and Pravastatin are not metabolized by any CYP.
The correct answer is D.
References:
https://www.ncbi.nlm.nih.gov/books/NBK532919/
https://pubmed.ncbi.nlm.nih.gov/20178046/#:~:text=HMG%2DCoA%20reductase%20inhibitors%20(statins)%20can%20cause%20skeletal%20muscle,that%20may%20mediate%20drug%20interactions.
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