Drug interactions between Lipitor and miconazole
| Results for the following 2 drugs: |
|---|
| Lipitor (atorvastatin) |
| miconazole |
Interactions between your selected drugs
miconazole ↔ atorvastatin
Applies to:miconazole and Lipitor (atorvastatin)
GENERALLY AVOID: Coadministration with potent inhibitors of CYP450 3A4 including azole antifungal agents may significantly increase the plasma concentrations of HMG-CoA reductase inhibitors that are substrates of the isoenzyme. High levels of HMG-CoA reductase inhibitory activity in plasma is associated with an increased risk of musculoskeletal toxicity. Myopathy manifested as muscle pain and/or weakness associated with grossly elevated creatine kinase exceeding ten times the upper limit of normal has been reported occasionally. Rhabdomyolysis has also occurred rarely, which may be accompanied by acute renal failure secondary to myoglobinuria and may result in death. The interaction has not been studied with clotrimazole troches or miconazole buccal tablets. Although systemic absorption following mucous membrane exposure is limited, the potential for interaction with drugs metabolized by CYP450 3A4 such as lovastatin, simvastatin, and atorvastatin cannot be ruled out.
MANAGEMENT: Given the potential for serious and life-threatening musculoskeletal toxicity associated with increased plasma levels of HMG-CoA reductase inhibitors, the concomitant use of lovastatin, red yeast rice (which contains lovastatin), and simvastatin with clotrimazole or miconazole mucous membrane preparations should be avoided if possible. Atorvastatin may be used with caution, although the dosage should start low and probably not exceed 40 mg/day. All patients treated with HMG-CoA reductase inhibitors should be advised to promptly report any unexplained muscle pain, tenderness, or weakness, particularly if accompanied by malaise or fever. Therapy should be discontinued if creatine kinase is markedly elevated in the absence of strenuous exercise or if myopathy is otherwise suspected or diagnosed. No interaction is expected with fluvastatin and pravastatin, since they are not metabolized by CYP450 3A4.
See also...
Drug Interaction Classification
The classifications below are a guideline only. The relevance of a particular drug interaction to a specific patient is difficult to determine using this tool alone given the large number of variables that may apply.
| Major | Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. |
| Moderate | Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. |
| Minor | Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. |
Do not stop taking any medications without consulting your healthcare provider.
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