Drug interactions
Atorvastatin + Letermovir
Severity: Major
Atorvastatin and Letermovir: 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
Letermovir increases atorvastatin exposure, raising the risk of myopathy and rhabdomyolysis. Atorvastatin may also affect letermovir through OATP1B1/3 competition, though this is less important.
What this interaction means in plain words
Atorvastatin and Letermovir 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; Letermovir belongs to Anti Virals.
Why it happens
Letermovir inhibits CYP3A4 and OATP1B1/3, reducing atorvastatin metabolism and hepatic uptake.
What to do
Limit atorvastatin to no more than 20 mg daily and monitor for myopathy. Avoid atorvastatin if letermovir is given with cyclosporine.
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 + Cobicistat Major
- Atorvastatin + Cyclosporin Major
- Atorvastatin + Cyclosporine Major
Other interactions of Letermovir
- Ergotamine + Letermovir Contraindicated
- Letermovir + Pimozide Contraindicated
- Apalutamide + Letermovir Major
- Carbamazepine + Letermovir Major
- Colchicine + Letermovir Major
- Cyclosporin + Letermovir Major
Frequently asked questions
Can I take Atorvastatin with Letermovir?
MediHelp rates the interaction as major. Atorvastatin and Letermovir 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. Letermovir increases atorvastatin exposure, raising the risk of myopathy and rhabdomyolysis. Atorvastatin may also affect letermovir through OATP1B1/3 competition, though this is less important.
How serious is the interaction between Atorvastatin and Letermovir?
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 no more than 20 mg daily and monitor for myopathy. Avoid atorvastatin if letermovir is given with cyclosporine.
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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