Drug interactions
Atorvastatin + Clarithromycin
Severity: Major
Atorvastatin and Clarithromycin: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Clarithromycin markedly increases atorvastatin exposure. This raises the risk of myopathy and rhabdomyolysis.
What this interaction means in plain words
Atorvastatin and Clarithromycin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Atorvastatin belongs to Cardiovascular; Clarithromycin belongs to Anti Bacterial.
Why it happens
Inhibition of CYP3A4, and also P-glycoprotein and OATP1B1 transport, by clarithromycin reduces atorvastatin clearance.
What to do
Limit atorvastatin to 20 mg daily per labeling or hold it during the clarithromycin course. Counsel the patient to report muscle pain or weakness.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Clarithromycin
- Astemizole + Clarithromycin Contraindicated
- Avanafil + Clarithromycin Contraindicated
- Cisapride + Clarithromycin Contraindicated
- Clarithromycin + Colchicine Contraindicated
- Clarithromycin + Conivaptan Contraindicated
- Clarithromycin + Dihydroergotamine Contraindicated
Other interactions of Atorvastatin
- Atorvastatin + Tipranavir Contraindicated
- Atazanavir + Atorvastatin Major
- Atorvastatin + Cobicistat Major
- Atorvastatin + Cyclosporin Major
- Atorvastatin + Cyclosporine Major
- Atorvastatin + Danazol Major
Frequently asked questions
Can I take Atorvastatin with Clarithromycin?
MediHelp rates the interaction as major. Atorvastatin and Clarithromycin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Clarithromycin markedly increases atorvastatin exposure. This raises the risk of myopathy and rhabdomyolysis.
How serious is the interaction between Atorvastatin and Clarithromycin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Limit atorvastatin to 20 mg daily per labeling or hold it during the clarithromycin course. Counsel the patient to report muscle pain or weakness.
What other medicines interact with Clarithromycin?
MediHelp also lists interactions of Clarithromycin with, for example, Astemizole, Avanafil, Cisapride. The full list is on the Clarithromycin page.
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