Atorvastatin and Tipranavir: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Jul 15, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Atorvastatin
Tipranavir
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 and an increased risk of myopathy and rhabdomyolysis
Interaction Deep Dive
Concomitant use of tipranavir/ritonavir and atorvastatin may cause significant increases in the plasma concentrations of atorvastatin. Tipranavir/ritonavir is a potent inhibitor of CYP3A4, and atorvastatin is a substrate of CYP3A4. The profound decrease in atorvastatin metabolism resulting from tipranavir/ritonavir CYP3A4 inhibition significantly increases the risk of myopathy and rhabdomyolysis3. Avoid concomitant use of atorvastatin with tipranavir/ritonavir due to an increased risk of myopathy/rhabdomyolysis1. Consider if the benefit of use of these products outweighs the increased risk of myopathy and rhabdomyolysis 2. If coadministration cannot be avoided, monitor for signs and symptoms of myopathy particularly during initiation of therapy and during upward dose titration of either drug 21.
Why it happens (mechanism)
Inhibition of CYP3A4-mediated metabolism of atorvastatin
Literature reports
2 reports — tap to read
a) Coadministration of tipranavir/ritonavir with atorvastatin may increased the plasma concentrations atorvastatin significantly. In one study subjects (n=22) received tipranavir 500 mg/ritonavir 200 mg twice daily for 17 doses and a single dose of 10 mg atorvastatin. Pharmacokinetic parameters were presented as the ratio of atorvastatin plus tipranavir/ritonavir to atorvastatin alone (90% CI). The ratios of maximum concentration (Cmax), area under the concentration-time curve (AUC) and minimum concentration (Cmin) of atorvastatin all showed a profound increase with results of 8.61 (range 7.25 to 10.21), 9.36 (range 1.43 to 1.73), and 5.19 (range 4.21 to 6.40), respectively. In a similar study 22 subjects received 14 doses of tipranavir 500 mg/ritonavir 200 mg twice daily and a single dose of atorvastatin 10 mg. Results were expressed as the ratio of tipranavir/ritonavir plus atorvastatin to tipranavir/ritonavir alone (90% CI). Ratios of the pharmacokinetic parameters Cmax, AUC, and Cmin demonstrated no significant change in plasma concentrations of tipranavir when coadministered with atorvastatin 3.
b) Coadministration of tipranavir 500 mg/ritonavir 200 mg twice daily with atorvastatin 10 mg once daily for 7 days increased the atorvastatin AUC by 9.36-fold and Cmax by 8.58-fold compared with atorvastatin alone 1.
Common questions
Can I take Atorvastatin and Tipranavir together?
Increased atorvastatin exposure and an increased risk of myopathy and rhabdomyolysis Always confirm with your pharmacist or prescriber before making any change.
How serious is the Atorvastatin and Tipranavir 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 Tipranavir 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 (3)
- Product Information: ATORVALIQ(R) oral suspension, atorvastatin calcium oral suspension. CMP Pharma Inc (per FDA), Farmville, NC, 2023. DailyMed
- Product Information: LIPITOR(R) oral tablets, atorvastatin calcium oral tablets. Viatris Specialty LLC (per FDA), Morgantown, WV, 2022. DailyMed
- Product Information: APTIVUS(R) oral capsules, tipranavir oral capsules. Boehringer Ingelheim Pharmaceuticals,Inc, Ridgefield, CT, 2007. DailyMed
Keep reading about Atorvastatin
Keep reading about Tipranavir
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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