藥物交互作用
Atorvastatin + Cyclosporine
嚴重程度: 嚴重
Atorvastatin and Cyclosporine: major interaction.
最後更新 來源: US FDA label
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摘要
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.
用白話說明這項交互作用的意義
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.
為什麼會發生
Cyclosporine inhibits OATP1B1 hepatic uptake and also inhibits CYP3A4 and P-gp, reducing atorvastatin clearance and increasing systemic levels.
處置方式
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.
可向藥師詢問的問題
- 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?
參考資料
Atorvastatin 的其他交互作用
常見問題
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.
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