The AUC of
atorvastatin is raised by 150% by
itraconazole. Rhabdomyolysis has been seen when
atorvastatin and
fluconazole have been given.
Because of the potentially serious reactions that can result, any patient given
atorvastatin with an azole should be told to report any unexplained muscle pain, tenderness or weakness. Because large increases in
atorvastatin levels can occur (most likely with
itraconazole or ketoconazole), consider temporarily withdrawing the statin. The manufacturers of
voriconazole recommend a dose reduction of
atorvastatin (and
lovastatin and simvastatin) during concurrent use. For
posaconazole, see
Simvastatin or Lovastatin, below.