Drug interactions
Atorvastatin + Erythromycin
Severity: Major
Atorvastatin and Erythromycin: major interaction.
Last updated Sources: US FDA label
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
Erythromycin raises atorvastatin exposure, increasing the risk of myopathy and rhabdomyolysis. The risk is higher at high statin doses, in older patients and with renal impairment.
What this interaction means in plain words
Atorvastatin and Erythromycin 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; Erythromycin belongs to Anti Bacterial.
Why it happens
CYP3A4 inhibition and possible OATP1B1 inhibition by erythromycin increase atorvastatin levels.
What to do
Temporarily withhold atorvastatin during the erythromycin course or choose a non-macrolide antibiotic; if combined, use the lowest statin dose and counsel on muscle symptoms.
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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References
Other interactions of Erythromycin
- Conivaptan + Erythromycin Contraindicated
- Dihydroergotamine intranasal + Erythromycin Contraindicated
- Dihydroergotamine + Erythromycin Contraindicated
- Domperidone + Erythromycin Contraindicated
- Dronedarone + Erythromycin Contraindicated
- Droperidol + Erythromycin Contraindicated
Other interactions of Atorvastatin
- Atorvastatin + Tipranavir Contraindicated
- Atazanavir + Atorvastatin Major
- Atorvastatin + Clarithromycin Major
- Atorvastatin + Cobicistat Major
- Atorvastatin + Cyclosporin Major
- Atorvastatin + Danazol Major
Frequently asked questions
Can I take Atorvastatin with Erythromycin?
MediHelp rates the interaction as major. Atorvastatin and Erythromycin 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. Erythromycin raises atorvastatin exposure, increasing the risk of myopathy and rhabdomyolysis. The risk is higher at high statin doses, in older patients and with renal impairment.
How serious is the interaction between Atorvastatin and Erythromycin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Temporarily withhold atorvastatin during the erythromycin course or choose a non-macrolide antibiotic; if combined, use the lowest statin dose and counsel on muscle symptoms.
What other medicines interact with Erythromycin?
MediHelp also lists interactions of Erythromycin with, for example, Conivaptan, Dihydroergotamine intranasal, Dihydroergotamine. The full list is on the Erythromycin page.
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