Quinine and Lovastatin: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Quinine
No brand names on recordLovastatin
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 lovastatin and increased risk of myopathy or rhabdomyolysis
Interaction Deep Dive
Using quinine together with lovastatin may result in increased lovastatin plasma concentrations resulting in increased risk of myopathy or rhabdomyolysis due to inhibition of CYP3A4-mediated lovastatin metabolism. Although, the pharmacokinetic parameters following administration of quinine with lovastatin have not been studied, 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 lovastatin 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, lovastatin should be discontinued1.
Why it happens (mechanism)
Inhibition of CYP3A-mediated lovastatin metabolism by quinine
Common questions
Can I take Quinine and Lovastatin together?
Increased plasma concentrations of lovastatin and increased risk of myopathy or rhabdomyolysis Always confirm with your pharmacist or prescriber before making any change.
How serious is the Quinine and Lovastatin 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 "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Quinine or Lovastatin 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 Quinine
Keep reading about Lovastatin
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