Be Aware of These Statin Drug Interactions

Statins are commonly prescribed to improve cholesterol levels. They lower LDL cholesterol (the "bad" cholesterol) and triglycerides while raising HDL ("good") cholesterol.

However, they also have the potential for drug interactions with common over-the-counter and prescription medications and some supplements. These interactions can interfere with the way the drug works, changing its effectiveness or causing side effects. In addition, if you have certain medical conditions, you should avoid statins or use them with caution.

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

This article discusses what medications may interact with statins. It also covers what medical conditions to report to your doctor before taking a statin.

Medical Conditions to Report

It is important to let your healthcare professional 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 that indicates inflammation or damage to liver cells.

Having liver disease doesn't automatically mean you can't use statins. However, it factors into the decision as to whether statins are the best or only options available. Cases of alcohol use disorder also require caution, since liver injury may occur when statins are added to the mix.

Possible Drug Interactions

Before taking statins, it's important to let your doctor know about any medications you're taking. That includes those prescribed to you by another healthcare provider, over-the-counter (OTC) drugs, and dietary or herbal supplements.

Some medications may interact with statins by decreasing the effectiveness of the statin. Others may increase the statin level in the blood to the point where it may become harmful to the body.

Be sure to tell your healthcare professional if you are already taking any of the medications below. If you are taking one of them, it doesn't mean that you can't take a statin. However, your healthcare professional may want to monitor you more closely since it may increase your risk of side effects.

Various statin drugs are metabolized or processed by your body differently. That means the potential for drug interactions can be different with various statins. It is usually possible to select a statin that minimizes potential drug interactions, depending on which medications you're taking.

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

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

• Antacids containing magnesium or aluminum hydroxide may decrease the concentration of some statins in the body. This may be prevented by taking your statin dose and antacid dose at least two hours apart.
• Antibiotics ending in -mycin such as erythromycin or Biaxin (clarithromycin) may increase the statins present in the blood and may also increase 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 in the blood. It may also increase statin side effects.
• Bile acid sequestrants may decrease the effectiveness of some statins. To avoid this, it may be recommended to take your statin dose and bile acid sequestrant dose at least four hours apart.
• Cordarone (amiodarone) may increase the amount of some statins present in the blood. It may also increase the side effects of statins.
• Coumadin (warfarin) along with a statin may reduce the blood's ability to clot.
• Fibrates may increase the risk of experiencing statin side effects.
• Fluvoxamine may increase the concentration of some statins present in the blood. It may also increase statin side effects.
• High blood pressure medications which are calcium channel blockers, such as diltiazem and verapamil, lower blood pressure but may also increase the statins present in the blood. They may also increase side effects.
• 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. They may also increase side effects.
• Lanoxin (digoxin) may increase the concentration of some statins in the body.
• Nicotinic acid (niacin) in high doses (greater than 1 gram a day) could increase the risk of experiencing statin side effects.
• Oral contraceptives and statins that are taken simultaneously may increase the concentration of these hormones in the body.
• Prilosec (omeprazole) may increase the amount of some statins present in the blood. It may also increase the side effects of statins.
• Sandimmune (cyclosporine) may increase the number of statins present in the blood and may also increase side effects.
• St. John's Wort may decrease the effectiveness of some 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.

Summary

Statin drugs can decrease bad cholesterol and increase good cholesterol. However, they can cause problems if you have certain medical conditions or if you're taking another medication or supplement with the statin.

Before taking statins, let your healthcare provider know if you have liver disease, or if you're pregnant or nursing. Also, be sure to tell them if you're taking any medications or supplements. They may want to monitor your condition or switch you to a different type of medicine.

A Word From Verywell

Statins can be beneficial in lowering cholesterol and decreasing your risk for heart disease. However, there are many precautions to be considered.

These are only a few of the possible drug interactions. That's why it's important to 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.