Major
Atorvastatin × Erythromycin
HMG-CoA reductase inhibitors (statins)×Macrolide antibiotic
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
Cap atorvastatin at 20 mg/day. Alternative – azithromycin.
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.