Can I take Atorvastatin and Clarithromycin together?

Why this happens

Clarithromycin blocks a specific enzyme in the liver (CYP3A4) that is responsible for breaking down atorvastatin. When this enzyme is blocked, atorvastatin builds up to dangerous levels in the body.

What you should do

You should not take these two medicines together. If you are prescribed clarithromycin, your doctor will usually advise you to temporarily stop taking atorvastatin until the course of antibiotics is finished. If you must take both, your doctor may prescribe a much lower dose of atorvastatin and monitor you closely. Seek medical help immediately if you experience unexplained muscle pain.

Important precautions

Drug-drug interaction

Do not take these two medicines together. Clarithromycin significantly increases the levels of atorvastatin in your blood, which can cause severe muscle breakdown (rhabdomyolysis) and kidney damage. Atorvastatin must be paused while taking this antibiotic.

Pregnancy

Do not take this medicine if you are pregnant or planning to become pregnant. It can cause serious harm to an unborn baby. Use effective contraception while taking it and for one month after stopping.

Muscle pain or weakness

You must report any unexplained muscle pain, tenderness, or weakness to a doctor immediately, especially if you also feel unwell or have a fever. This can be a sign of a rare but serious muscle breakdown.

Food and drink warnings

Grapefruit juice

Grapefruit juice contains compounds that can increase the level of atorvastatin in your blood. This can increase your risk of side effects, such as muscle pain or damage. You should avoid drinking large quantities (more than 1.2 litres per day), but it is safest to avoid grapefruit juice altogether while taking this medicine.

Alcohol

Drinking large amounts of alcohol while taking atorvastatin can increase the risk of liver problems. It is recommended to stay within the low-risk weekly guidelines (no more than 14 units per week).

Food (General)

Clarithromycin can be taken with or without food. However, if you find that the medicine upsets your stomach, taking it with a meal or a snack may help reduce these side effects.

Using other medicines

Taking multiple medicines? Our Medicines Interaction Checker helps you check whether your prescriptions, over-the-counter medicines, and supplements are safe to take together. Simply search for your medicines to see potential interactions and what to do about them.

Disclaimer

This information is for general educational purposes only and should not be relied upon as a substitute for professional medical advice. Always consult your GP, pharmacist, or another qualified healthcare professional before making decisions about your medications. Individual circumstances may vary, and only a healthcare professional who knows your medical history can provide personalised guidance.