CriticalHMG-CoA reductase inhibitors (statins)×Macrolide antibiotic
Updated · Methodology
Mechanism
Erythromycin inhibits CYP3A4. Atorvastatin rises 2-3 fold. FDA recommends dose cap.
Symptoms
Myalgia, weakness, dark urine, rising CK within 5-10 days.
Management
The AEMPS label for erythromycin lists the combination with atorvastatin as contraindicated. The FDA label caps atorvastatin at 20 mg/day instead. Alternative antibiotic: azithromycin, which does not inhibit CYP3A4; otherwise pause the statin for the course.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.
Summary of a multi-drug list →
Medicine list: everything you take in one place →
Sources
- FDA: Lipitor (atorvastatin) prescribing information, Section 7 Drug Interactions (2017)
- AEMPS: Ficha técnica: Eritromicina (nº registro 79380), sección 4.3 (2025)– AEMPS, CIMA, nº registro 79380, sección 4.3