Drug Interaction Report

Cholestyramine may interfere with the absorption of atorvastatin when they are taken at the same time or within a short time of each other. This may reduce the blood levels and effects of atorvastatin. To prevent or minimize the risk of interaction, atorvastatin should be taken at least 4 hours after cholestyramine. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Using cholestyramine (sometimes called a "bile acid sequestrant") together with ezetimibe may decrease the effects of ezetimibe. These two medications are often used together to treat high cholesterol, but may need to be taken at different times. In general, ezetimibe should be administered at least 2 hours before or 4 hours after cholestyramine. You may need additional blood work to ensure that this combination is working. Talk to your healthcare provider if you have any questions. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Using ezetimibe together with atorvastatin can increase the risk of side effects such as liver damage and a rare but serious condition called rhabdomyolysis that involves the breakdown of skeletal muscle tissue. In some cases, rhabdomyolysis can cause kidney damage and even death. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Let your doctor know immediately if you have unexplained muscle pain, tenderness, or weakness while taking these medications, especially if these symptoms are accompanied by fever or dark colored urine. You should also seek immediate medical attention if you develop fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, dark colored urine, and/or yellowing of the skin or eyes, as these may be signs and symptoms of liver damage. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Grapefruit juice can increase the blood levels of atorvastatin. This can increase the risk of side effects such as liver damage and a rare but serious condition called rhabdomyolysis that involves the breakdown of skeletal muscle tissue. In some cases, rhabdomyolysis can cause kidney damage and even death. You should limit your consumption of grapefruit juice to no more than 1 quart per day during treatment with atorvastatin. Let your doctor know immediately if you have unexplained muscle pain, tenderness, or weakness during treatment, especially if these symptoms are accompanied by fever or dark colored urine. You should also seek immediate medical attention if you develop fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, dark colored urine, and/or yellowing of the skin or eyes, as these may be signs and symptoms of liver damage. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Cholestyramine may interfere with the absorption of certain vitamins such as A, D, E and K. Therefore, it is recommended that you take multivitamin with minerals at least 1 hour before or 4 to 6 hours after cholestyramine to minimize the risk of interaction. Talk to your doctor or pharmacist if you have questions on how to take these or other medications you are prescribed. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.