X-Tin Drug Interactions

Atorvastatin undergoes metabolism by CYP3A4 so avoid concomitant administration of atorvastatin with inhibitors of CYP3A4 (e.g., protease inhibitors, azole antifungal agents, macrolide antibiotics, verapamil, diltiazem, grapefruit juice, niacin). Because it can lead to elevated plasma levels, increasing the risk of myopathy and rhabdomyolysis. Rifampin is CYP3A4 inducer, atorvastatin level may be reduced, decreasing the pharmacologic effects.
When used concomitantly with digoxin, plasma concentrations of digoxin may be elevated and increasing the risk of toxicity due to atorvastatin can increase absorption of digoxin by inhibition of p-glycoprotein-mediated secretion of digoxin in the intestine.
Use concurrently with bile acid-binding resins may decrease plasma concentration of atorvastatin about 25% by reducing the gastrointestinal (GI) absorption which due to atorvastatin may adsorb to the bile acid-binding resins.
Use concurrently with cyclosporine may decrease metabolism of atorvastatin leading to increased plasma levels and side effects such as myolysis and rhabdomyolysis.
Use concomitantly with gemfibrozil may cause severe myopathy or rhabdomyolysis by unknown mechanism.
Concurrent administration with oral contraceptive may increase AUC for ethinyl estradiol and norethindrone about 20% and 30%.