Simeprevir and Atorvastatin: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Jul 15, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Atorvastatin
Simeprevir
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 or rhabdomyolysis
Interaction Deep Dive
Concomitant use of atorvastatin, a CYP3A and OATP substrate, and simeprevir, a CYP3A and OATP inhibitor, is not recommended, as this may result in increased atorvastatin exposure and increased risk of atorvastatin adverse effects. Coadministration of a single dose of atorvastatin with simeprevir for 10 days resulted in a 2-fold increase in atorvastatin AUC and Cmax3. If coadministration is clinically necessary, use the lowest dose of atorvastatin possible and do not exceed a daily dose of 40 mg 31. In patients taking simeprevir, consider the risk/benefit of concomitant use with atorvastatin 2. Monitor for signs and symptoms of myopathy particularly during initiation of therapy and during upward dose titration of either drug 1.
Why it happens (mechanism)
Inhibition of CYP3A4-mediated metabolism of atorvastatin by simeprevir; inhibition of OATP1B1-mediated efflux transport of atorvastatin; inhibition of OATP1B3-mediated efflux transport of atorvastatin; inhibition of P-gp-mediated efflux transport of atorvastatin
Literature reports
1 report — tap to read
a) During drug interaction studies in healthy adults (n=18), coadministration of a single dose of atorvastatin 40 mg and simeprevir 150 mg once daily for 10 days resulted in increased atorvastatin AUC and Cmax of approximately 2-fold (2.12; 90% CI, 1.72 to 2.62 and 1.7; 1.42 to 2.04, respectively) 31.
Common questions
Can I take Simeprevir and Atorvastatin together?
Increased atorvastatin exposure and an increased risk of myopathy or rhabdomyolysis Always confirm with your pharmacist or prescriber before making any change.
How serious is the Simeprevir 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 "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 Simeprevir 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 (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: OLYSIO(TM) oral capsules, simeprevir oral capsules. Janssen Therapeutics (per manufacturer), Titusville, NJ, 2013.
Keep reading about Atorvastatin
Keep reading about Simeprevir
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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