CriticalHMG-CoA reductase inhibitors (statins)×Second-generation systemic triazole antifungal
Updated · Methodology
Mechanism
Posaconazole is a strong CYP3A4 inhibitor. Atorvastatin rises 3-4 fold.
Symptoms
Myalgia, weakness, dark urine, rising CK within 5-10 days.
Management
The AEMPS label for posaconazole lists the combination with atorvastatin as contraindicated. The FDA label caps atorvastatin at 10 mg/day instead. For the posaconazole course, pause the statin or switch to pravastatin or rosuvastatin, which do not depend on CYP3A4.
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
- FDA: Lipitor (atorvastatin) prescribing information, Section 7 Drug Interactions (2017)
- AEMPS: Ficha técnica: Posaconazol (nº registro 90284), sección 4.3 (2025)– AEMPS, CIMA, nº registro 90284, sección 4.3