Which of the following statins is NOT metabolized by CYP3A4?

Fluvastatin

(B) is the correct answer here. Fluvastatin is metabolized by 2C9. The point of this question is to understand that three statins: simvastatin, atorvastatin, and lovastatin, are metabolized by 3A4. 40% of drugs have some sort of interaction (metabolized, inducer, inhibitor) with 3A4 and makes the interaction relevant. For instance, the HIV protease inhibitor, ritonavir, is one of the most potent inhibitors of 3A4. Concomitant administration of ritonavir and simvastatin is so dangerous (less metabolism of simvastatin and thus higher risk for adverse effects) that it is contraindicated. The same is true for drugs such as cyclosprine, erythromycin, and even gemfibrozil. Fluvastatin is not without interactions. A fair amount of drugs use 2C9 in some way, such as phenytoin and amiodarone.