Atorvastatin and Diltiazem interaction

Atorvastatin and Diltiazem: both prescribing labels flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.

Major

Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.

What the FDA labels say

From the Diltiazem (DILTIAZEM HYDROCHLORIDE in SODIUM CHLORIDE) label · effective 2025-04-15

Major

Statins: Avoid statins metabolized by CYP3A4.

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Moderate

Statins Increased risk of myopathy and rhabdomyolysis with statins metabolized by CYP3A4.

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Minor

When possible, use a non-CYP3A4-metabolized statin with diltiazem.

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From the Atorvastatin (Lipitor) label · effective 2024-04-15

Moderate

LIPITOR plasma levels can be significantly increased with concomitant administration of inhibitors of CYP3A4 and transporters.

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Moderate

Table 2: Drug Interactions that may Increase the Risk of Myopathy and Rhabdomyolysis with LIPITOR Cyclosporine or Gemfibrozil Clinical Impact: Atorvastatin plasma levels were significantly increased with concomitant administration of LIPITOR and cyclosporine, an inhibitor of CYP3A4 and OATP1B1 [see Clinical Pharmacology (12.3) ] .

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Moderate

Anti-Viral Medications Clinical Impact: Atorvastatin plasma levels were significantly increased with concomitant administration of LIPITOR with many anti-viral medications, which are inhibitors of CYP3A4 and/or transporters (e.g., BCRP, OATP1B1/1B3, P-gp, MRP2, and/or OAT2) [see Clinical Pharmacology (12.3) ] .

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Not medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.