CYP3A4 and Miyoshi myopathy: Proposed mechanisms for clarithromycin’s effect include increasing the concentration of dexamethasone through cytochrome P450 3A4 (CYP3A4) inhibition, downregulation of T-reg cell response via decreased interleukin (IL)-6 and increased IL-10 and interferon (IFN)-y levels [121, 122], and through attenuation of autophagy in MM cells [123].