Some evidence suggests that atorvastatin, and possibly other CYP3A4-metabolised
statins (e.g. simvastatin) may interfere with the antiplatelet actions of clopidogrel, but data from some large
clinical studies suggests no clinically relevant interaction occurs.
Although an interaction has been demonstrated, the anticipated negative effect on
clinical outcomes has not been consistently shown. The beneficial properties of
statins may offset any attenuating effects on the antiplatelet action of
clopidogrel. Some have suggested that
pravastatin and
rosuvastatin may be preferred; however others consider there is insufficient data to warrant changing
clinical practice, and given the established
clinical benefits of the combination, this seems the most appropriate course of action.