Drug Interaction Report

Rosuvastatin and Gemfibrozil: Interaction Details

A pharmacist-reviewed analysis of the Rosuvastatin 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

Rosuvastatin

Crestor Crestor® Ezallor Ezallor®
+

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 24 documented Rosuvastatin interactions, 21 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
established
Severity
Major

What happens

Increased rosuvastatin exposure and an increased risk of myopathy and rhabdomyolysis

Interaction Deep Dive

Concomitant use of rosuvastatin and gemfibrozil (an OATP1B1 transporter inhibitor) has resulted in 1.9-fold increase in the AUC21 and 2.2-fold increase in the Cmax of rosuvastatin. This increase is considered to be clinically significant. Due to the risk of myopathy and rhabdomyolysis with combined therapy, avoid concomitant treatment where possible . If concomitant use cannot be avoided, initiate rosuvastatin at 5 mg once daily. Do not exceed a dosage of rosuvastatin 10 mg/day 2. The concomitant use of gemfibrozil and rosuvastatin/ezetimibe is not recommended 3.

Why it happens (mechanism)

Inhibition of OATP1B1-mediated rosuvastatin transport by gemfibrozil

Literature reports

2 reports — tap to read

a) Concomitant use of rosuvastatin and gemfibrozil (an OATP1B1 transporter inhibitor) has resulted in a 1.9-fold increase in rosuvastatin AUC 1.

b) Administration of a single dose of rosuvastatin 80 mg to healthy volunteers receiving gemfibrozil (600 mg twice daily for 7 days) resulted in 1.9-fold increase in the AUC and 2.2-fold increase in the Cmax of rosuvastatin 23.

Common questions

Can I take Rosuvastatin and Gemfibrozil together?

Increased rosuvastatin exposure and an increased risk of myopathy and rhabdomyolysis Always confirm with your pharmacist or prescriber before making any change.

How serious is the Rosuvastatin 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 "established". Well documented — supported by controlled studies or strong clinical data.

Questions for your pharmacist

  • Does my dose of Rosuvastatin 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 (3)

  1. Tornio A, Neuvonen PJ, Niemi M, et al: Role of gemfibrozil as an inhibitor of CYP2C8 and membrane transporters. Expert Opin Drug Metab Toxicol 2017; 13(1):83-95. PubMed
  2. Product Information: CRESTOR(R) oral tablets, rosuvastatin calcium oral tablets. AstraZeneca Pharmaceuticals LP (per FDA), Wilmington, DE, 2024. DailyMed
  3. Product Information: ROSZET oral tablets, rosuvastatin ezetimibe oral tablets. Althera Pharmaceuticals LLC (per FDA), Wilmington, DE, 2024.
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Rosuvastatin

Keep reading about Rosuvastatin

All Rosuvastatin interactions (24) Rosuvastatin drug information
Also serious with: Cyclosporine Injection Asciminib Eluxadoline 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:

Rosuvastatin + Activated Charcoal Beer Grapefruit Siberian Cocklebur Wine Ashwagandha Black Cohosh Black Tea + 55 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.