Ciprofloxacin and Atorvastatin: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Jul 15, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Atorvastatin
Ciprofloxacin
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
An increased risk of myopathy or rhabdomyolysis
Interaction Deep Dive
Concomitant use of atorvastatin and ciprofloxacin may result in myopathy, rhabdomyolysis, or hepatic dysfunction. Monitor for changes in liver function and muscle enzymes if concurrent therapy is required1.
Why it happens (mechanism)
Inhibition of CYP3A4-mediated atorvastatin metabolism by ciprofloxacin
Literature reports
1 report — tap to read
a) In a systematic review evaluating drug interactions between statins and quinolones, 16 case reports were identified and described adverse events including rhabdomyolysis (n=12), muscle weakness (n=1), hip tendinopathy (n=1), myopathy (n=1), and acute hepatitis (n=1). The dose and type of statins varied among the case reports, and included simvastatin (n=10) at a dose range of 20 to 80 mg/day and atorvastatin (n=4) at a dose of 80 mg/day. The quinolones that were coadministered included ciprofloxacin (n=9) at a dose range of 800 to 1500 mg/day, levofloxacin (n=6) at a dose range of 250 to 1000 mg/day, and norfloxacin (n=1) in an unspecified dose range. Approximately 80% of patients were over the age of 60 years, about 30% had kidney disease, and 62% of the patients were on concomitant CYP3A4 inhibitors, P-gp inhibitors, or OATP1B1 inhibitors. All cases required hospitalization. Seven cases required discontinuation of both the statin and quinolone; 4 cases discontinued only the statin, 2 cases discontinued only the quinolone, and 1 patient was switched to a different statin. Symptoms improved in all patients within 3 to 28 days. Patients treated with ciprofloxacin or levofloxacin with simvastatin or high-dose atorvastatin should be monitored for changes in liver function and muscle enzymes, especially if they are over 60 years of age, have kidney disease, or on concomitant CYP3A inhibitors 1.
Common questions
Can I take Ciprofloxacin and Atorvastatin together?
An increased risk of myopathy or rhabdomyolysis Always confirm with your pharmacist or prescriber before making any change.
How serious is the Ciprofloxacin and Atorvastatin 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:
- Can I Take Ginkgo With Apixaban (Eliquis) and Atorvastatin?
- Is It Safe to Drink Motherwort Tea While Taking Atorvastatin?
- Can You Split Lipitor (Atorvastatin) Tablets In Half?
- Can Ciprofloxacin INCREASE Appetite?
- Does Coconut Water Interact With Ciprofloxacin?
- Can You Take Cipro (Ciprofloxacin) With Alcohol?
Questions for your pharmacist
- Does my dose of Ciprofloxacin or Atorvastatin 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 (1)
- Zhou J, Yu L, & Xu H: A systematic review of the drug-drug interaction between statins and quinolones. BMC Pharmacol Toxicol 2024; 25(1):39. PubMed
Keep reading about Atorvastatin
Keep reading about Ciprofloxacin
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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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