Lipistad Drug Interactions

The risk of myopathy during treatment with drugs of this class is increased with concurrent administration of cyclosporine, fibric acid derivatives, niacin (nicotinic acid), erythromycin, azole antifungals.
Co-administration of strong CYP3A4 inhibitors (e.g. ciclosporin, telithromycin, clarithromycin, delavirdine, stiripentol, ketoconazole, voriconazole, itraconazole, posaconazole and HIV protease inhibitors including ritonavir, lopinavir, atazanavir, indinavir, darunavir, etc) should be avoided if possible. In cases where co-administration of these medicinal products with atorvastatin cannot be avoided, lower starting and maximum doses of atorvastatin should be considered and appropriate clinical monitoring of the patient is recommended. In patients taking telaprevir, concomitant use of atorvastatin should be avoided. The dose of atorvastatin should not exceed 40 mg daily when taking with boceprevir and close clinical monitoring is recommended.
Colestipol: Plasma concentrations of atorvastatin decreased approximately 25% when colestipol and atorvastatin were coadministered. However, LDL-C reduction was greater when atorvastatin and colestipol were coadministered than when either drug was given alone.
Digoxin: When multiple doses of atorvastatin and digoxin were coadministered, steady state plasma digoxin concentrations increased by approximately 20%. Patients taking digoxin should be monitored appropriately.
Erythromycin: In healthy individuals, plasma concentrations of atorvastatin increased approximately 40% with coadministration of atorvastatin and erythromycin, a known inhibitor of cytochrome P450 3A4.
Oral contraceptives: Coadministration of atorvastatin and an oral contraceptive increased AUC values for norethindrone and ethinylestradiol by approximately 30% and 20%. These increases should be considered when selecting an oral contraceptive for a woman taking atorvastatin.
10 mg: Antacids: plasma concentrations of atorvastatin decreased. However, LDL-C reduction was not altered.
20 mg: Coadministration of atorvastatin and inhibitors of cytochrome P450 3A4 may increase the risk of myopathy and rhabdomyolysis by increasing atorvastatin concentration in plasma during therapy.
Warfarin: Atorvastatin had no clinically significant effect on prothrombin time when administered to patients receiving chronic warfarin treatment.
Grapefruit juice: Concomitant oral administration of grapefruit juice and atorvastatin should be discouraged since this combination may increase the risk of adverse effects.