MajorHMG-CoA reductase inhibitors (statins)×Antifungal, triazole
Updated · Methodology
Mechanism
Itraconazole inhibits CYP3A4 and P-glycoprotein. Atorvastatin concentration rises 3–4 fold. FDA does not contraindicate the combination outright but caps atorvastatin at 20 mg/day and requires CK monitoring.
Symptoms
Myalgia and weakness within 1–3 weeks; CK above 5× ULN.
Management
Cap atorvastatin at 20 mg/day. For short itraconazole courses (up to 14 days) the safer option is to hold atorvastatin altogether.
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 (2017)– ; DailyMed setid a60cc18b-0631-4cf0-b021-9f52224ece65
- AEMPS: Ficha técnica: Atorvastatina (nº registro 69536), sección 4.5 (2024)– AEMPS, CIMA, nº registro 69536, sección 4.5