Drug Interaction Report

Pitavastatin and Gemfibrozil: Interaction Details

A pharmacist-reviewed analysis of the Pitavastatin and Gemfibrozil interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Pitavastatin

Livalo Livalo® Nikita Zypitamag Zypitamag®
+

Gemfibrozil

Lopid Lopid®
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Dr. Brian Staiger, PharmD, BCPS
Updated Aug 8, 2026
Editorial policy · Data sources
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Interaction severity
Major
Potentially serious — often needs a change or close monitoring.
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.

Of 19 documented Pitavastatin interactions, 14 are rated major — including this one.
Worried about symptoms right now? Contact your pharmacist or prescriber, or call Poison Control at 1-800-222-1222 (US). Call 911 for an emergency.
Onset
unspecified
Evidence
probable
Severity
Major

What happens

Increased pitavastatin plasma concentrations and increased risk of myopathy or rhabdomyolysis

Interaction Deep Dive

The concomitant use of gemfibrozil and pitavastatin has resulted in increased pitavastatin exposure and may increase the risk of myopathy and rhabdomyolysis22. The AUC and Cmax of pitavastatin increased 45% and 31%, respectively when coadministered with gemfibrozil, compared with pitavastatin alone 2. The concomitant use of gemfibrozil and HMG-CoA reductase inhibitors has markedly elevated creatine kinase (CPK) levels, and myoglobinuria, resulting in cases of acute renal failure and death. In patients not adequately responded to the individual drug therapy, the benefit of combined therapy does not outweigh the risks 1 and should be avoided 2.

Why it happens (mechanism)

Unknown

Literature reports

2 reports — tap to read

a) Cases of myopathy or rhabdomyolysis with or without acute renal failure have been reported as early as 3 weeks after initiation of combined gemfibrozil and HMG-CoA reductase inhibitor therapy or after several months. There is no guarantee that periodic monitoring of creatine kinase will prevent the occurrence of severe myopathy and kidney damage 1.

b) In a study of the effects of the concomitant use of gemfibrozil 600 mg twice a day and pitavastatin 4 mg once a day for 7 days, the AUC of pitavastatin increased 45% and Cmax increased by 31% when coadministered with gemfibrozil, compared with pitavastatin alone 2.

Common questions

Can I take Pitavastatin and Gemfibrozil together?

Increased pitavastatin plasma concentrations and increased risk of myopathy or rhabdomyolysis Always confirm with your pharmacist or prescriber before making any change.

How serious is the Pitavastatin and Gemfibrozil 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.

Questions for your pharmacist

  • Does my dose of Pitavastatin or Gemfibrozil 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 (2)

  1. Product Information: LOPID(R) oral tablets, gemfibrozil oral tablets. Parke-Davis, New York, NY, 2009. DailyMed
  2. Product Information: LIVALO(R) oral tablets, pitavastatin oral tablets. Kowa Pharmaceuticals America, Inc. and Lilly USA, LLC (per FDA), Montgomery, AL, 2012. DailyMed
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Pitavastatin

Keep reading about Pitavastatin

All Pitavastatin interactions (19) Pitavastatin drug information
Also serious with: Cyclosporine Injection Cyclosporine Ophthalmic Fluorouracil Injection Niacin
Gemfibrozil

Keep reading about Gemfibrozil

All Gemfibrozil interactions (80) Gemfibrozil drug information
Also serious with: Grazoprevir Ciprofibrate Dasabuvir Elagolix
Beyond drug–drug

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:

Pitavastatin + Activated Charcoal Beer Grapefruit Siberian Cocklebur Wine Adrafinil African Wild Potato Ashwagandha + 118 more
Gemfibrozil + Activated Charcoal Beer Siberian Cocklebur Wine Ashwagandha Black Cohosh Boldo Buchu + 51 more

major · moderate · minor — check everything you take with our drug–supplement interaction checker.

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This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.