Moderate
Atorvastatin × Omeprazole
HMG-CoA reductase inhibitors (statins)×Proton pump inhibitors
Mechanism
Omeprazole weakly blocks CYP3A4 – atorvastatin exposure rises modestly (by 10–20%). Clinically significant myopathy beyond baseline is rare.
Symptoms
Usually no changes. In patients with risk factors (older age, chronic kidney disease, hypothyroidism): muscle pain and weakness possible.
Management
The combination is acceptable without dose change. In patients with myopathy risk factors, check creatine kinase on muscle symptoms. Alternative PPI without CYP3A4 effect: pantoprazole or rabeprazole.
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.
Sources
- Lexicomp: Lexicomp Drug Interactions (2024)– Wolters Kluwer Clinical Drug Information, Inc. Lexi-Interact Online, 2024
- Pharmaceutical Press: Stockley's Drug Interactions, 12th edition (2024)– Preston CL (ed.). Stockley's Drug Interactions. 12th ed. London: Pharmaceutical Press; 2024