Drug interactions
Atorvastatin + Sirolimus
Severity: Moderate
Atorvastatin and Sirolimus: moderate 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
Sirolimus is a CYP3A4 and P-glycoprotein substrate, and atorvastatin is a weak P-glycoprotein inhibitor, so sirolimus levels may rise slightly. Both drugs raise lipids or require lipid management, and combined use can increase muscle toxicity risk in transplant patients.
What this interaction means in plain words
Atorvastatin and Sirolimus can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Atorvastatin belongs to Cardiovascular; Sirolimus belongs to Miscellaneous.
Why it happens
Possible weak P-glycoprotein inhibition by atorvastatin; additive myopathy risk.
What to do
Monitor sirolimus trough levels when atorvastatin is started or changed. Use the lowest effective statin dose and monitor for muscle symptoms.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Atorvastatin
- Atorvastatin + Tipranavir Contraindicated
- Atazanavir + Atorvastatin Major
- Atorvastatin + Clarithromycin Major
- Atorvastatin + Cobicistat Major
- Atorvastatin + Cyclosporin Major
- Atorvastatin + Danazol Major
Other interactions of Sirolimus
- Adenovirus types 4 and 7 live + Sirolimus Contraindicated
- Bcg vaccine live + Sirolimus Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Sirolimus Contraindicated
- Ketoconazole + Sirolimus Contraindicated
- Levoketoconazole + Sirolimus Contraindicated
- Measles mumps and rubella vaccine live + Sirolimus Contraindicated
Frequently asked questions
Can I take Atorvastatin with Sirolimus?
MediHelp rates the interaction as moderate. Atorvastatin and Sirolimus can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Sirolimus is a CYP3A4 and P-glycoprotein substrate, and atorvastatin is a weak P-glycoprotein inhibitor, so sirolimus levels may rise slightly. Both drugs raise lipids or require lipid management, and combined use can increase muscle toxicity risk in transplant patients.
How serious is the interaction between Atorvastatin and Sirolimus?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor sirolimus trough levels when atorvastatin is started or changed. Use the lowest effective statin dose and monitor for muscle symptoms.
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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