Can You Take Atorvastatin with Clarithromycin?
Last reviewed: · Source: US FDA drug label database
Clarithromycin dramatically raises atorvastatin levels, increasing the risk of severe muscle damage (rhabdomyolysis) — statins are usually paused during a clarithromycin course.
Is it safe to take Atorvastatin with Clarithromycin?
Clarithromycin is a potent inhibitor of the enzyme (CYP3A4) that clears atorvastatin from the body. Taking them together can multiply atorvastatin blood levels several-fold, greatly increasing the risk of muscle pain, muscle breakdown (rhabdomyolysis), and kidney failure. Standard practice is to temporarily stop atorvastatin during a short clarithromycin course and restart afterwards — but only do this on your prescriber's or pharmacist's instruction.
How do Atorvastatin and Clarithromycin interact?
Atorvastatin is a CYP3A4 substrate; clarithromycin is a strong CYP3A4 and OATP1B1 inhibitor. Co-administration increases atorvastatin AUC substantially. Elevated statin exposure is directly linked to myopathy risk; case reports of rhabdomyolysis with acute kidney injury exist for this exact pair.
Data sourced from the US Food and Drug Administration (FDA) drug label database: OpenFDA atorvastatin label — CYP3A4 inhibitor interaction warnings.
Who should be careful?
Everyone on this pair — but especially the elderly, people with kidney impairment, hypothyroidism, high statin doses (40-80mg), or those also taking amlodipine or other interacting drugs.
What if I've already taken Atorvastatin and Clarithromycin?
If you've taken both, watch for muscle pain, tenderness, weakness, or dark (cola-coloured) urine — these need urgent medical attention. Contact your pharmacist or GP about pausing the statin for the rest of the antibiotic course.
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Frequently Asked Questions
Can I take atorvastatin with clarithromycin?
No — this combination should be avoided. Your statin is usually paused during the antibiotic course. Confirm the plan with your prescriber.
What are the warning signs of statin muscle damage?
Unexplained muscle pain, tenderness or weakness, and dark cola-coloured urine. If these occur, seek urgent medical advice.
Which antibiotics are safe with atorvastatin?
Amoxicillin, doxycycline, and most cephalosporins do not significantly interact. Azithromycin interacts much less than clarithromycin but still warrants caution.
Should I just skip my statin during antibiotics?
Often yes for a short clarithromycin course — but only pause a prescribed medicine on your prescriber's or pharmacist's advice, and remember to restart.