Atorvastatin and Darunavir: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Jul 15, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Atorvastatin
Darunavir
No brand names on record
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Increased atorvastatin exposure, an increased darunavir exposure and an increased risk of myopathy or rhabdomyolysis
Interaction Deep Dive
Coadministration of atorvastatin and darunavir significantly increased atorvastatin exposure and may increase the risk of myopathy or rhabdomyolysis. If coadministered, start with the lowest recommended atorvastatin dose. Adjust the atorvastatin dose while monitoring for safety. Use the lowest clinically effective atorvastatin dose and do not exceed a dosage of 20 mg daily. Coadministration of darunavir and atorvastatin (CYP3A4 substrate) may also increase darunavir exposure23. Monitor the patient for signs and symptoms of myopathy or rhabdomyolysis (eg, muscle pain, tenderness, or weakness), particularly during the initial months of therapy and during upward dosage titration of either drug 1.
Why it happens (mechanism)
Inhibition of CYP3A4-mediated metabolism of atorvastatin; inhibition of CYP3A4-mediated metabolism of darunavir
Literature reports
2 reports — tap to read
a) Subjects receiving atorvastatin 10 mg daily for 4 days who were coadministered darunavir 300 mg/ritonavir 100 mg twice daily for 9 days had a 3.4-fold increase in atorvastatin AUC and a 2.25-fold increase in Cmax 1.
b) In a pharmacokinetics study, coadministration of atorvastatin with darunavir/ritonavir significantly increased atorvastatin plasma trough concentrations. In 15 subjects, pharmacokinetic parameters of atorvastatin 10 mg orally once daily concurrently with darunavir 300 mg/ritonavir 100 mg orally twice daily were compared with atorvastatin 40 mg orally once daily (eg, with/without). While coadministration of atorvastatin with darunavir/ritonavir, at 75% reduction in atorvastatin dose, resulted in a 44% decrease in atorvastatin Cmax (least squares (LS) mean ratio with/without darunavir, 0.56; 90% CI, 0.48 to 0.67), and a 15% decrease in atorvastatin AUC (LS mean ratio, 0.85; 90% CI, 0.76 to 0.97) values; the atorvastatin Cmin increased 81% (LS mean ratio ,1.81; 90% CI, 1.37 to 2.40) 4.
Common questions
Can I take Atorvastatin and Darunavir together?
Increased atorvastatin exposure, an increased darunavir exposure and an increased risk of myopathy or rhabdomyolysis Always confirm with your pharmacist or prescriber before making any change.
How serious is the Atorvastatin and Darunavir interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "established". Well documented — supported by controlled studies or strong clinical data.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Atorvastatin or Darunavir need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (4)
- Product Information: LIPITOR(R) oral tablets, atorvastatin calcium oral tablets. Viatris Specialty LLC (per FDA), Morgantown, WV, 2022. DailyMed
- Product Information: PREZCOBIX® PED oral tablets for suspension, darunavir cobicistat oral tablets for suspension. Janssen Products, LP (per FDA), Horsham, PA, 2026. DailyMed
- Product Information: PREZCOBIX® oral tablets, darunavir cobicistat oral tablets. Janssen Products, LP (per FDA), Horsham, PA, 2026. DailyMed
- Product Information: PREZISTA(R) oral suspension, oral film coated tablets, darunavir oral suspension, oral film coated tablets. Janssen Therapeutics (per manufacturer), Titusville, NJ, 2012. DailyMed
Keep reading about Atorvastatin
Keep reading about Darunavir
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