Drug interactions between Lipitor and Serzone
| Results for the following 2 drugs: |
|---|
| Lipitor (atorvastatin) |
| Serzone (nefazodone) |
Interactions between your selected drugs
nefazodone ↔ atorvastatin
Applies to:Serzone (nefazodone) and Lipitor (atorvastatin)
GENERALLY AVOID: Coadministration with nefazodone may significantly increase the plasma concentrations of HMG-CoA reductase inhibitors that are metabolized by CYP450 3A4 such as atorvastatin, cerivastatin, lovastatin, and simvastatin. The mechanism is decreased clearance due to inhibition of CYP450 3A4 activity by nefazodone. Nefazodone has been reported to increase systemic exposure (AUC) of simvastatin and its pharmacologically active acid metabolite by 20-fold and atorvastatin AUC by 3.4-fold. 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. There have been case reports of patients treated with simvastatin who developed severe myopathy or rhabdomyolysis during coadministration of nefazodone.
MANAGEMENT: Nefazodone should generally not be used in combination with atorvastatin, cerivastatin, lovastatin, simvastatin, and red yeast rice (which contains lovastatin) due to the potential for severe interaction. Fluvastatin, pravastatin, and rosuvastatin are not expected to interact with nefazodone, since they are not metabolized by CYP450 3A4, although pravastatin was cited in a case report of suspected interaction that resulted in asymptomatic increases in creatine kinase levels. All patients receiving statin therapy should be advised to promptly report any unexplained muscle pain, tenderness or weakness, particularly if accompanied by fever, malaise and/or dark-colored urine. Therapy should be discontinued if creatine kinase is markedly elevated in the absence of strenuous exercise or if myopathy is otherwise suspected or diagnosed.
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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