Atorvastatin and Quinine: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Jul 15, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Atorvastatin
Quinine
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 plasma concentrations of atorvastatin and increased risk of myopathy or rhabdomyolysis
Interaction Deep Dive
Using quinine together with atorvastatin may result in increased atorvastatin plasma concentrations resulting in an increased risk of myopathy or rhabdomyolysis due to inhibition of CYP3A4-mediated atorvastatin metabolism. Although no formal drug interaction studies have been performed with quinine and atorvastatin, a case report describes rhabdomyolysis with acute renal failure secondary to myoglobinuria in a patient taking atorvastatin who was administered a single dose of quinine. If the benefits of concomitant use outweigh the potential risks, consider using the lowest effective starting and maintenance doses of atorvastatin and monitor closely for statin toxicity, particularly with initial therapy. For patients who develop markedly elevated creatine phosphokinase (CPK) levels, or if myopathy (defined as muscle aches or muscle weakness in conjunction with CPK levels greater than 10 times the ULN) is diagnosed or suspected, atorvastatin should be discontinued1.
Why it happens (mechanism)
Inhibition of CYP3A-mediated atorvastatin metabolism by quinine
Common questions
Can I take Atorvastatin and Quinine together?
Increased plasma concentrations of atorvastatin and increased risk of myopathy or rhabdomyolysis Always confirm with your pharmacist or prescriber before making any change.
How serious is the Atorvastatin and Quinine interaction?
It is rated moderate. Can be significant — usually manageable with 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 Quinine 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 anything you'd monitor while I'm on both?
References (1)
- Product Information: QUALAQUIN(R) oral capsules, quinine sulfate oral capsules. AR Scientific, Inc. Philadelphia, PA, 2010. DailyMed
Keep reading about Atorvastatin
Keep reading about Quinine
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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