Atorvastatin and Fenofibrate: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Jul 15, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Atorvastatin
Fenofibrate
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
An increased risk of myopathy or rhabdomyolysis
Interaction Deep Dive
Avoid concomitant use of fenofibrate and atorvastatin, as it may increase the risk of myopathy or rhabdomyolysis2, unless the potential benefit from further lipid level adjustments outweighs the increased risk of rhabdomyolysis 34. Consider if the benefit of using fibrates concomitantly with atorvastatin outweighs the increased risk of myopathy and rhabdomyolysis. If concomitant use is decided, monitor patients for signs and symptoms of myopathy, particularly during initiation of therapy and during upward dose titration of either drug 1. Discontinue atorvastatin if markedly elevated creatine kinase (CK) levels occur or if myopathy is either diagnosed or suspected. Muscle symptoms and CK elevations may resolve if atorvastatin is discontinued 5. Data from observational studies indicate that the risk for rhabdomyolysis is increased when fibrates are coadministered with a statin. Coadministration of atorvastatin, 20 mg once daily for 10 days, with fenofibrate, 160 mg once daily for 10 days, reduced the AUC and Cmax of fenofibrate by 2% and 4% respectively 2.
Why it happens (mechanism)
Additive risk of myopathy
Literature reports
5 reports — tap to read
a) Atorvastatin AUC values decreased by approximately 17% (range from 67% decrease to 44% increase) following the concomitant administration of fenofibrate 145 mg and atorvastatin 20 mg once daily for 10 days by 22 healthy males. Fenofibrate did not significantly affect atorvastatin Cmax values. The pharmacokinetics of fenofibric acid were not significantly affected by atorvastatin 4.
b) Coadministration of single dose atorvastatin 40 mg with fenofibrate 160 mg once daily for 7 days led to a 1.03-fold increase in atorvastatin AUC and a 1.02-fold increase in Cmax 5.
c) Coadministration of atorvastatin, 20 mg once daily for 10 days, with fenofibric acid, 160 mg once daily for 10 days, led to a 2% decrease in fenofibric acid AUC and a 4 % decrease in Cmax 6.
d) Atorvastatin AUC values decreased by approximately 17% following the concomitant administration of fenofibrate 160 mg (fenofibric acid is the active metabolite of fenofibrate) and atorvastatin 20 mg once daily for 10 days. Fenofibrate did not significantly affect atorvastatin Cmax values. The pharmacokinetics of fenofibric acid were not significantly affected by atorvastatin 6.
e) Data from observational studies indicate that the risk for rhabdomyolysis is increased when fibrates are coadministered with a statin. Coadministration of atorvastatin, 20 mg once daily for 10 days, with fenofibrate, 160 mg once daily for 10 days, reduced the AUC and Cmax of fenofibrate by 2% and 4% respectively. Whereas, coadministration of pravastatin, 40 mg as a single dose, with fenofibrate, three times 67 mg(2) as a single dose, reduced the AUC and Cmax of fenofibrate by 1% and 2% respectively. And, coadministration of fluvastatin, 40 mg as a single dose, with fenofibrate, 160 mg once single dose, reduced the AUC and Cmax of fenofibrate by 2% and 10% respectively 2.
Common questions
Can I take Atorvastatin and Fenofibrate together?
An increased risk of myopathy or rhabdomyolysis Always confirm with your pharmacist or prescriber before making any change.
How serious is the Atorvastatin and Fenofibrate 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 "probable". Good supporting evidence, though not definitively proven.
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 Fenofibrate 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 (6)
- Product Information: LIPITOR(R) oral tablets, atorvastatin calcium oral tablets. Viatris Specialty LLC (per FDA), Morgantown, WV, 2024. DailyMed
- Product Information: TRIGLIDE(R) oral tablets, fenofibrate oral tablets. Casper Pharma LLC (per FDA), East Brunswick, NJ, 2024. DailyMed
- Product Information: ANTARA(R) oral capsules, fenofibrate micronized oral capsules. Lupin Pharmaceuticals Inc (per FDA), Naples, FL, 2024. DailyMed
- Product Information: TRICOR oral tablets, fenofibrate oral tablets. AbbVie Inc (per FDA), North Chicago, IL, 2021. DailyMed
- Product Information: ATORVALIQ(R) oral suspension, atorvastatin calcium oral suspension. CMP Pharma Inc (per FDA), Farmville, NC, 2024. DailyMed
- Product Information: FIBRICOR(R) oral tablets, fenofibric acid oral tablets. Athena Bioscience LLC (per FDA), Athens, GA, 2021. DailyMed
Keep reading about Atorvastatin
Keep reading about Fenofibrate
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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