Gemfibrozil and Rosuvastatin interaction
Gemfibrozil and Rosuvastatin: both prescribing labels flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.
Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.
What the FDA labels say
From the Gemfibrozil (Lopid) label · effective 2026-05-21
Avoid concomitant use of LOPID with rosuvastatin.
If concomitant use cannot be avoided, initiate rosuvastatin at 5 mg once daily.
Drug Interactions (A) HMG-CoA Reductase Inhibitors The concomitant administration of LOPID with simvastatin is contraindicated (see CONTRAINDICATIONS and WARNINGS ).
OATP1B1 substrates – Gemfibrozil is an inhibitor of organic anion-transporter polyprotein (OATP) 1B1 and may increase exposure of drugs that are substrates of OATP1B1 (e.g., atrasentan, atorvastatin, bosentan, ezetimibe, fluvastatin, glyburide, SN-38 [active metabolite of irinotecan], rosuvastatin, pitavastatin, pravastatin, rifampin, valsartan, olmesartan).
The dose of rosuvastatin should not exceed 10 mg once daily.
From the Rosuvastatin (Crestor) label · effective 2026-04-29
Steps to Prevent or Reduce the Risk of Myopathy and Rhabdomyolysis The concomitant use of CRESTOR with cyclosporine or gemfibrozil is not recommended.
Gemfibrozil Prevention or Management: Avoid concomitant use of gemfibrozil with CRESTOR.
Mechanism and Clinical Effect(s): Gemfibrozil significantly increased rosuvastatin exposure and gemfibrozil may cause myopathy when given alone.
Niacin, fibrates, and colchicine may also increase the risk of myopathy and rhabdomyolysis [see Drug Interactions (7.1) ] .
Fenofibrates (e.g., fenofibrate and fenofibric acid) Prevention or Management: Consider if the benefit of using fibrates concomitantly with CRESTOR outweighs the increased risk of myopathy and rhabdomyolysis.
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Open in the checkerNot 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.