Drug interactions
Atorvastatin + Cobicistat
Severity: Major
Atorvastatin and Cobicistat: 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
Cobicistat is a strong CYP3A inhibitor and increases atorvastatin exposure. This raises the risk of myopathy and rhabdomyolysis.
What this interaction means in plain words
Atorvastatin and Cobicistat 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; Cobicistat belongs to Miscellaneous.
Why it happens
Inhibition of CYP3A4-mediated atorvastatin metabolism, and possibly OATP transport, by cobicistat.
What to do
Start with the lowest atorvastatin dose and do not exceed 20 mg daily. Monitor for muscle pain, weakness and CK elevations.
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 Atorvastatin
- Atorvastatin + Tipranavir Contraindicated
- Atazanavir + Atorvastatin Major
- Atorvastatin + Clarithromycin Major
- Atorvastatin + Cyclosporin Major
- Atorvastatin + Cyclosporine Major
- Atorvastatin + Danazol Major
Other interactions of Cobicistat
- Alfuzosin + Cobicistat Contraindicated
- Apalutamide + Cobicistat Contraindicated
- Cobicistat + Colchicine Contraindicated
- Cobicistat + Dronedarone Contraindicated
- Cobicistat + Eletriptan Contraindicated
- Cobicistat + Eplerenone Contraindicated
Frequently asked questions
Can I take Atorvastatin with Cobicistat?
MediHelp rates the interaction as major. Atorvastatin and Cobicistat 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. Cobicistat is a strong CYP3A inhibitor and increases atorvastatin exposure. This raises the risk of myopathy and rhabdomyolysis.
How serious is the interaction between Atorvastatin and Cobicistat?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Start with the lowest atorvastatin dose and do not exceed 20 mg daily. Monitor for muscle pain, weakness and CK elevations.
What other medicines interact with Atorvastatin?
MediHelp also lists interactions of Atorvastatin with, for example, Tipranavir, Atazanavir, Clarithromycin. The full list is on the Atorvastatin page.
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