相互作用
Atorvastatin + Cyclosporine
重症度: 重大
Atorvastatin and Cyclosporine: major interaction.
最終更新日 出典: US FDA label
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概要
Cyclosporine markedly increases atorvastatin exposure, raising the risk of myopathy and rhabdomyolysis. Atorvastatin labeling advises avoiding the combination. Transplant recipients, older patients and those with renal impairment are at particular risk.
この相互作用をわかりやすく説明すると
Atorvastatin and Cyclosporine 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.
なぜ起こるのか
Cyclosporine inhibits OATP1B1 hepatic uptake and also inhibits CYP3A4 and P-gp, reducing atorvastatin clearance and increasing systemic levels.
対処法
Avoid concomitant use per atorvastatin labeling; consider fluvastatin, pravastatin or rosuvastatin at limited doses as recommended in their labels. If a statin is required, use the lowest effective dose and monitor for muscle symptoms, with CK measurement if they appear.
薬剤師に尋ねること
- 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?
Pro+会員向け
ページ全体を見る
アカウントを作成してPro+トライアルを始めると、AtorvastatinとCyclosporineの臨床対応の詳細なアドバイス、追加の注記、エビデンスの詳細、処方全体を対象とした相互作用チェッカーを利用できます。
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
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参考文献
Atorvastatinのその他の相互作用
よくある質問
Can I take Atorvastatin with Cyclosporine?
MediHelp rates the interaction as major. Atorvastatin and Cyclosporine 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. Cyclosporine markedly increases atorvastatin exposure, raising the risk of myopathy and rhabdomyolysis. Atorvastatin labeling advises avoiding the combination. Transplant recipients, older patients and those with renal impairment are at particular risk.
How serious is the interaction between Atorvastatin and Cyclosporine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid concomitant use per atorvastatin labeling; consider fluvastatin, pravastatin or rosuvastatin at limited doses as recommended in their labels. If a statin is required, use the lowest effective dose and monitor for muscle symptoms, with CK measurement if they appear.
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.
完全なモノグラフ、用量、相互作用チェッカーはMediHelpアプリで
MediHelpアプリで、完全なリファレンスを開き、複数薬剤の相互作用をチェックし、用量ツールを利用できます。
