Be Aware of These Statin Drug Interactions

16 Medications That May Trigger Adverse Events

Statin pill next to a blister pack

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Statins are commonly prescribed to lower cholesterol levels. However, they also have the potential for drug interactions, including many common over-the-counter and prescription medications and some supplements. Statins should also be avoided by people with certain medical conditions or only used with caution.

For these reasons, it's important that you discuss your medical history and everything you are taking with your doctor.

Statins Are Not for Everyone

Statins are a class of cholesterol-lowering drugs that target all aspects of your lipid profile. They can successfully lower LDL cholesterol (the "bad" cholesterol) and triglycerides while raising HDL ("good") cholesterol.

Although they are very effective in lowering cholesterol levels, statins may not be for everyone. There are some things you should let your healthcare provider know before you begin statin therapy.

This includes any medical conditions you may have or any medications you are taking. Medications are not limited to those prescribed to you by another physician but include over-the-counter (OTC) and dietary or herbal supplements as well.

Additionally, if you receive medical treatment from someone other than your healthcare provider, you should let that person know that you are taking a statin.

Medical Conditions to Report

It is important to let your healthcare provider know about any medical condition you have before you start taking statins.

Chief among these is liver disease. Statins can further impair liver function, causing an elevation in liver enzymes indicative of inflammation. Liver disease doesn't automatically exclude statin use, but it factors into the decision as to whether statins are the best or only options available. Care also needs to be taken in cases of alcohol abuse, in which liver injury may occur when statins are added to the mix.

Statins are contraindicated in pregnancy due to early reports that the drugs may cause birth defects. Although a number of studies have questioned the association, it is nevertheless wise to avoid the drugs just in case.

The same applies to the use of statins during breastfeeding, since the drugs can be passed in breast milk to your baby.

Possible Drug Interactions

Some medications may interact with statins by either decreasing the effectiveness of the statin or increasing the statin level in the blood to the point where it may become harmful to the body. Be sure to tell your healthcare provider if you are already taking any of the medications below.

Just because you are on any of these medications, it does not mean that you are not able to take a statin. However, your healthcare provider may want to monitor you more closely while on any of these because they may increase your risk of side effects.

Keep in mind that this is not a complete list and you should consult your healthcare provider for further information.

Always read the package insert to identify the drug interactions specific to the statin you are taking, whether it is Crestor (rosuvastatin), Lescol (fluvastatin), Lipitor (atorvastatin), Mevacor (lovastatin), Pravachol (pravastatin), or Zocor (simvastatin).

This is a general list of medical conditions and medications that you should be aware of:

  • Nicotinic acid (niacin) in high doses (greater than 1 gram a day) could increase the risk of experiencing statin side effects.
  • Bile acid sequestrants may decrease the effectiveness of some statins. To avoid this, it may be recommended to separate your statin dose and bile acid sequestrant dose by at least four hours.
  • Fibrates may increase the risk of experiencing statin side effects.
  • Sandimmune (cyclosporine) may increase the number of statins present in the blood and may also increase side effects.
  • Fluvoxamine may increase the concentration of some statins present in the blood and may also increase statin side effects.
  • Antifungal drugs ending in -azole, such as Nizoral (ketoconazole), Diflucan (fluconazole), Mycelex (miconazole), or Sporanox (itraconazole), may increase the amount of some statins present in the blood and may also increase statin side effects.
  • Antibiotics ending in -mycin such as erythromycin or Biaxin (clarithromycin) may increase the statins present in the blood and may also increase side effects.
  • High blood pressure medications, such as diltiazem and verapamil, may increase the statins present in the blood and may also increase side effects.
  • Cordarone (amiodarone) may increase the amount of some statins present in the blood and may also increase the side effects of statins.
  • HIV protease inhibitors, such as Norvir (ritonavir), Agenerase (amprenavir), Crixivan (indinavir), or Viracept (nelfinavir), may increase the amount of some statins present in the blood and may also increase side effects.
  • Coumadin (warfarin) along with a statin may reduce the blood's ability to clot.
  • Prilosec (omeprazole) may increase the amount of some statins present in the blood and may also increase the side effects of statins.
  • Tagamet (cimetidine) may increase the amount of some statins present in the blood and may also increase the side effects of statins.
  • Zantac (ranitidine) may increase the amount of some statins present in the blood and may also increase the side effects of statins.
  • Oral contraceptives and statins that are taken simultaneously may increase the concentration of these hormones in the body.
  • Lanoxin (digoxin) may increase the concentration of some statins in the body.
  • Antacids containing magnesium or aluminum hydroxide may decrease the concentration of some statins in the body. This may be prevented by separating your statin dose and antacid dose by at least two hours.
  • St. John's Wort may decrease the effectiveness of some statins.

A Word From Verywell

While statins can be beneficial in lowering cholesterol and decreasing your risk for heart disease, you can see that there are many precautions to be considered. These are only a few of the possible drug interactions, which is why it is very important that you discuss your medical history and all medications—prescription or otherwise—with your healthcare team before taking a statin.

It is important to remember that statins are not the only treatment for high cholesterol. Nicotinic acid, fibric acid, PCSK9 inhibitors, bile acid sequestrants, and Zeta (ezetimibe) can also be used if statins are not an option.

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Article Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial policy to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Gillett RC Jr, Norrell A. Considerations for safe use of statins: liver enzyme abnormalities and muscle toxicity. Am Fam Physician. 2011 Mar 15;83(6):711-6.


Additional Reading

  • Lacy CF, Armstrong LL, Goldman MP, et al. Lexicomp's Drug Information Handbook. 26th ed. Hudson, OH:Lexi-Comp Inc.; 2017.

  • Dipiro JT, Talbert RL. Pharmacotherapy: A Pathophysiologic Approach. 10th ed. New York, NY: McGraw-Hill Education. 2017.