{"id":49922,"date":"2022-04-04T17:09:38","date_gmt":"2022-04-04T21:09:38","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=49922"},"modified":"2025-09-12T13:21:25","modified_gmt":"2025-09-12T17:21:25","slug":"atorvastatin-interactions","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/atorvastatin-interactions\/","title":{"rendered":"Lipitor interactions with drugs, vitamins, and foods"},"content":{"rendered":"

Drug interactions<\/a> | Vitamin and supplement interactions<\/a> | Food interactions<\/a> | Other contraindications<\/a> | Signs of an interaction <\/a><\/span><\/p>\n

Lipitor<\/span><\/a>, the brand name for <\/span>atorvastatin calcium<\/span><\/a>, is a common medication used to help lower LDL (bad) cholesterol and triglycerides in the blood. <\/span>Hypercholesterolemia<\/span><\/a> is a type of hyperlipidemia that involves having too much non-HDL cholesterol and LDL cholesterol in the blood. This condition increases fatty deposits in arteries and the risk of blockages that can lead to cardiovascular disease. Available as an oral tablet, atorvastatin can reduce the risk of angina, stroke, heart attack, or certain heart and blood vessel problems. Like <\/span>other statin medications<\/span><\/a>, atorvastatin works to prevent cholesterol from being made in the liver. As a widely used medication, it\u2019s important for people to be aware of the Lipitor (atorvastatin) interactions with other prescription drugs, food, and vitamins.<\/span><\/p>\n

RELATED: <\/b>Lipitor coupons<\/b><\/a> | <\/b>13 things you might not know about Lipitor<\/b><\/a><\/p>\n

Drug interactions<\/span><\/h2>\n

Along with other statin drugs<\/a>, atorvastatin can interact with some prescription and over-the-counter medications. These <\/span>atorvastatin interactions<\/span><\/a> may cause increased levels of atorvastatin in the body contributing to a higher risk of side effects, or decreased levels of atorvastatin in the body contributing to possible ineffective doses. Increased levels of atorvastatin are associated with a higher chance of adverse effects, including myopathy, rhabdomyolysis, and liver enzyme abnormalities.\u00a0<\/span><\/p>\n

On the other hand, drug interactions with atorvastatin may lead to increased or decreased plasma concentrations of other drugs. These interactions may cause adverse effects as a result of too much of the interacting medication or cause an ineffective dose as a result of not enough of the interacting medication.<\/span><\/p>\n

Myopathy is a muscle disease that can be caused by statins. Symptoms of <\/span>statin-induced myopathy<\/span><\/a> include muscle weakness, fatigue, muscle pain, nocturnal cramping, muscle tenderness, and tendon pain. <\/span>Rhabdomyolysis <\/span><\/a>is a more serious condition that occurs when damaged muscle tissue releases its proteins and electrolytes into the blood. This process can result in permanent disability or fatality.\u00a0<\/span><\/p>\n

Liver enzyme abnormalities may indicate inflammation or damage to cells in the liver. A blood test can show elevated liver enzymes (most commonly ALT or AST) as the inflammation or damage can cause these enzymes to leak into the bloodstream. Before starting therapy with atorvastatin or another statin medication, the prescribing doctor may check liver enzymes with a blood test to ensure statin therapy is appropriate.<\/span><\/p>\n

RELATED: <\/b>Lipitor side effects and how to avoid them<\/b><\/a><\/p>\n

A few medications are contraindicated with atorvastatin, which means that the combination is known to be harmful. These medications include cisapride, lonafarnib, posaconazole, and ritonavir.\u00a0<\/span><\/p>\n

There are other medications that should be avoided or used with caution and monitored. It\u2019s always important to review all new medications with a healthcare provider to prevent dangerous drug interactions.\u00a0<\/span><\/p>\n

When it comes to atorvastatin, it\u2019s important to be aware of using it along with medications used for the immune system, cholesterol, infections, birth control, heart failure, HIV or AIDS, and hepatitis C virus.<\/span><\/p>\n

Lipitor (atorvastatin)<\/span><\/a>, <\/span>Mevacor (lovastatin)<\/span><\/a>, and <\/span>Zocor (simvastatin)<\/span><\/a> are three statin medications referred to as statin 3A4 substrates. Statins that do not use the CYP3A4 isoenzyme metabolic pathway are referred to as statin non-3A4 substrates (pravastatin, fluvastatin, pitavastatin, and rosuvastatin). Some medications can slow down the CYP3A4 (cytochrome P450 3A4) metabolic pathway and are referred to as <\/span>CYP3A4 inhibitors<\/span><\/a>. These medications can prevent CYP3A4 isoenzymes from breaking down other drugs, such as atorvastatin, lovastatin, or simvastatin. As a result of this inhibition, levels of atorvastatin, lovastatin, or simvastatin may increase and lead to significant statin toxicity. Strong CYP3A4 inhibitors include <\/span>clarithromycin<\/span><\/a>, <\/span>itraconazole<\/span><\/a>, and certain antiviral medications used to treat <\/span>HIV<\/span><\/a> and <\/span>hepatitis C<\/span><\/a>.<\/span><\/p>\n

RELATED: <\/b>Statin side effects and how to combat them<\/b><\/a><\/p>\n\n\n\n\n\n\n\n\n\n\n\n
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Atorvastatin interactions by drug class<\/span><\/h3>\n<\/th>\n<\/tr>\n<\/thead>\n

Drug class<\/b><\/td>\nExamples of drugs<\/b><\/td>\nSeverity of interaction<\/b><\/td>\nRisks<\/b><\/td>\n<\/tr>\n
Certain antifungals<\/td>\n\n
    \n
  • Fluconazole<\/li>\n
  • Itraconazole<\/li>\n
  • Ketoconazole<\/li>\n
  • Posaconazole<\/li>\n
  • Voriconazole<\/li>\n<\/ul>\n<\/td>\n
\n
    \n
  • Contraindicated with posaconazole<\/li>\n
  • Monitor\/modify with others listed<\/li>\n<\/ul>\n<\/td>\n
\n
    \n
  • Increases atorvastatin levels, risk of myopathy, rhabdomyolysis, and other serious side effects<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n
Certain antivirals (including protease inhibitors)<\/td>\n\n
    \n
  • Glecaprevir<\/li>\n
  • Letermovir<\/li>\n
  • Pibrentasvir<\/li>\n
  • Ritonavir<\/li>\n
  • Tipranavir<\/li>\n<\/ul>\n<\/td>\n
\n
    \n
  • Contraindicated with ritonavir<\/li>\n
  • Avoid\/use alternative with others listed<\/li>\n<\/ul>\n<\/td>\n
\n
    \n
  • Increases atorvastatin levels, risk of myopathy and rhabdomyolysis<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n
Antibiotics ending in -mycin<\/i><\/td>\n\n
    \n
  • Erythromycin<\/li>\n
  • Clarithromycin<\/li>\n<\/ul>\n<\/td>\n
\n
    \n
  • Avoid\/use alternative<\/li>\n<\/ul>\n<\/td>\n
\n
    \n
  • Increases atorvastatin levels and increases side effects<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n
Fibrates<\/td>\n\n
    \n
  • Fenofibrate<\/li>\n
  • Fenofibric acid<\/li>\n
  • Gemfibrozil<\/li>\n<\/ul>\n<\/td>\n
\n
    \n
  • Avoid\/use alternative<\/li>\n<\/ul>\n<\/td>\n
\n
    \n
  • Increases atorvastatin levels, risk of myopathy and rhabdomyolysis<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n
Certain heart medications<\/td>\n\n
    \n
  • Amiodarone<\/li>\n
  • Digoxin<\/li>\n<\/ul>\n<\/td>\n
\n
    \n
  • Monitor\/modify<\/li>\n<\/ul>\n<\/td>\n
\n
    \n
  • Increases concentrations of digoxin<\/li>\n
  • Increases concentrations of atorvastatin with concomitant use of amiodarone<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n
Oral contraceptives<\/td>\n\n
    \n
  • Loestrin<\/li>\n
  • Microgestin<\/li>\n
  • Norethindrone<\/li>\n<\/ul>\n<\/td>\n
\n
    \n
  • Monitor\/modify<\/li>\n<\/ul>\n<\/td>\n
\n