Drug interactions
Atorvastatin + Itraconazole
Severity: Major
Atorvastatin and Itraconazole: 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
Itraconazole increases atorvastatin exposure, raising the risk of myopathy and rhabdomyolysis. The risk rises with higher statin doses.
What this interaction means in plain words
Atorvastatin and Itraconazole 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; Itraconazole belongs to Anti Fungals.
Why it happens
Strong CYP3A4 inhibition by itraconazole reduces atorvastatin metabolism, with possible transporter effects.
What to do
Limit atorvastatin to 20 mg daily during itraconazole therapy, or temporarily hold the statin. Counsel patients to report muscle pain and check CK if symptoms occur.
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 Itraconazole
- Alfuzosin + Itraconazole Contraindicated
- Alprazolam + Itraconazole Contraindicated
- Avanafil + Itraconazole Contraindicated
- Conivaptan + Itraconazole Contraindicated
- Dihydroergotamine intranasal + Itraconazole Contraindicated
- Dihydroergotamine + Itraconazole 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 Itraconazole?
MediHelp rates the interaction as major. Atorvastatin and Itraconazole 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. Itraconazole increases atorvastatin exposure, raising the risk of myopathy and rhabdomyolysis. The risk rises with higher statin doses.
How serious is the interaction between Atorvastatin and Itraconazole?
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 during itraconazole therapy, or temporarily hold the statin. Counsel patients to report muscle pain and check CK if symptoms occur.
What other medicines interact with Itraconazole?
MediHelp also lists interactions of Itraconazole with, for example, Alfuzosin, Alprazolam, Avanafil. The full list is on the Itraconazole page.
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