Drug & supplement interaction

Green Tea + Atorvastatin Calcium

Atorvastatin Calcium brand name: Lipitor.

Major Interaction
The bottom line Major

Atorvastatin Calcium falls into 4 drug categories that Green Tea can interact with; the most serious is rated major. Green tea extract seems to reduce the levels and clinical effects of atorvastatin.

Read the full interaction report
SeverityMajor
LikelihoodLikely
Interactions4
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Green Tea and Atorvastatin Calcium

These two interact in 4 distinct ways. Each one is explained separately below.

Why Are There 4 Interactions?

Green Tea interacts with whole categories of medication. Atorvastatin Calcium falls into 4 of those categories, so it can interact with Green Tea in 4 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Major).

Major

ATORVASTATIN (Lipitor)

1 of 4
Green tea extract seems to reduce the levels and clinical effects of atorvastatin.
In healthy humans, taking green tea extract 300 mg or 600 mg along with atorvastatin reduces plasma levels of atorvastatin by approximately 24%. The elimination of atorvastatin is not affected. Atorvastatin is a substrate of organic anion-transporting polypeptides (OATPs). Research shows that two of the major catechins found in green tea, epicatechin gallate (ECG) and epigallocatechin gallate (EGCG), inhibit OATPs. Some OATPs are expressed in the small intestine and are responsible for the uptake of drugs and other compounds, which may have resulted in reduced plasma levels of atorvastatin. It is not clear if drinking green tea alters the absorption of atorvastatin.
Severity Major Likelihood Likely Evidence B

Well-controlled human studies have demonstrated the likely existence of this interaction.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the interesting part with this combination: green tea doesn't make your atorvastatin (Lipitor) stronger, it actually seems to make it weaker. In studies, concentrated green tea extract (around 300 to 600 mg) lowered the amount of atorvastatin getting into the blood by about a quarter. The likely reason is that green tea catechins block a gut transporter called OATP that helps absorb the drug, so less of it makes it in.

What does that mean for you? Mainly that your cholesterol medicine may not work quite as well, so your LDL (the "bad" cholesterol) might not drop as much as expected. This was seen with concentrated extract pills, not necessarily a normal cup or two of tea. Please don't stop either one. Just check with your pharmacist or doctor, especially if you take green tea supplements.

References
  1. Roth M, Timmermann BN, Hagenbuch B. Interactions of green tea catechins with organic anion-transporting polypeptides. Drug Metab Dispos 2011;39:920-6. PubMed
  2. Abdelkawy KS, Abdelaziz RM, Abdelmageed AM, Donia AM, El-Khodary NM. Effects of green tea extract on atorvastatin pharmacokinetics in healthy volunteers. Eur J Drug Metab Pharmacokinet. 2020;45(3):351-360. PubMed
Moderate

HEPATOTOXIC DRUGS

2 of 4

Why this applies to Atorvastatin Calcium

Atorvastatin Calcium falls under HEPATOTOXIC DRUGS — the group Green Tea interacts with.

Theoretically, concomitant use might have additive adverse hepatotoxic effects.
Green tea extract supplements have been linked to several cases of hepatotoxicity and might have additive hepatotoxic effects with other drugs..
Severity Moderate Likelihood Unlikely Evidence D

Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist: both atorvastatin and concentrated green tea extract are processed by your liver, and on rare occasions each one has been tied to liver irritation. The worry on file is simply that stacking two things that can stress the liver might, in theory, add up. This isn't a strong or well-proven concern, and it's considered unlikely to happen. The evidence here is mostly anecdotal, so I don't want you to panic over it.

One important point: a cup or two of brewed green tea is very different from a high-dose green tea extract capsule, which is where the rare liver reports come from. Watch for signs like yellowing skin or eyes, dark urine, unusual tiredness, or belly pain, and check with your pharmacist or doctor before starting a green tea supplement.

References
  1. Bonkovsky HL. Hepatotoxicity associated with supplements containing Chinese green tea (Camellia sinensis). Ann Intern Med 2006;144:68-71.
  2. Gloro R, Hourmand-Ollivier I, Mosquet B, et al. Fulminant hepatitis during self-medication with hydroalcoholic extract of green tea. Eur J Gastroenterol Hepatol 2005;17:1135-7. PubMed
  3. Jimenez-Saenz M, Martinez-Sanchez, MDC. Acute hepatitis associated with the use of green tea infusions. J Hepatol 2006;44:616-9. PubMed
  4. Javaid, A. and Bonkovsky, H. L. Hepatotoxicity due to extracts of Chinese green tea (Camellia sinensis): a growing concern. J Hepatol 2006;45(2):334-335. PubMed
  5. Martinez-Sierra, C., Rendon, Unceta P., and Martin, Herrera L. [Acute hepatitis after green tea ingestion]. Med Clin (Barc.) 6-17-2006;127(3):119.
  6. Molinari, M., Watt, K. D., Kruszyna, T., Nelson, R., Walsh, M., Huang, W. Y., Nashan, B., and Peltekian, K. Acute liver failure induced by green tea extracts: case report and review of the literature. Liver Transpl. 2006;12(12):1892-1895. PubMed
  7. Federico, A., Tiso, A., and Loguercio, C. A case of hepatotoxicity caused by green tea. Free Radic.Biol Med 8-1-2007;43(3):474. PubMed
  8. Sarma, D. N., Barrett, M. L., Chavez, M. L., Gardiner, P., Ko, R., Mahady, G. B., Marles, R. J., Pellicore, L. S., Giancaspro, G. I., and Low, Dog T. Safety of green tea extracts : a systematic review by the US Pharmacopeia. Drug Saf 2008;31(6):469-484. PubMed
  9. Rohde, J., Jacobsen, C., and Kromann-Andersen, H. [Toxic hepatitis triggered by green tea]. Ugeskr.Laeger 1-17-2011;173(3):205-206.
  10. Yellapu, R. K., Mittal, V., Grewal, P., Fiel, M., and Schiano, T. Acute liver failure caused by 'fat burners' and dietary supplements: a case report and literature review. Can.J.Gastroenterol. 2011;25(3):157-160. PubMed
  11. Health Canada. Health Product Info Watch. October 2016; 5-6. Available at: http://www.hc-sc.gc.ca/dhp-mps/medeff/bulletin/hpiw-ivps_2016-10-eng.php#a15.
  12. Oketch-Rabah HA, Roe AL, Rider CV, et al. United States Pharmacopeia (USP) comprehensive review of the hepatotoxicity of green tea extracts. Toxicol Rep. 2020;7:386-402. PubMed
  13. Pochet S, Lechon AS, Lescrainier C, et al. Herb-anticancer drug interactions in real life based on VigiBase, the WHO global database. Sci Rep 2022;12(1):14178. PubMed
Moderate

ORGANIC ANION-TRANSPORTING POLYPEPTIDE SUBSTRATES (OATP)

3 of 4

Atorvastatin Calcium also falls under ORGANIC ANION-TRANSPORTING POLYPEPTIDE SUBSTRATES (OATP).

Theoretically, green tea might reduce the absorption of organic anion-transporting polypeptide (OATP) substrates.
OATPs are expressed in the small intestine and liver and are responsible for the uptake of drugs and other compounds. Research shows that two of the major catechins found in green tea, epicatechin gallate (ECG) and epigallocatechin gallate (EGCG), inhibit OATPs, specifically OATP1A2, OATP1B1, and OATP2B1. In addition, green tea has been shown to reduce the absorption of some drugs that are OATP substrates, including lisinopril, and celiprolol.
Severity Moderate Likelihood Probable Evidence D

Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist: your body uses little transporter proteins called OATPs to pull atorvastatin (Lipitor) from your gut into your blood and liver, where it does its cholesterol-lowering work. Green tea catechins, especially EGCG, can block those transporters in the lab. In theory, that could mean a bit less atorvastatin gets absorbed, which might make it slightly less effective at lowering your LDL ('bad') cholesterol.

I want to be honest about the evidence here. This is mostly lab and animal data, not solid human studies on atorvastatin itself, so it's more of a theoretical concern than a proven problem. A cup or two of regular green tea is unlikely to matter much. Concentrated green tea extract pills are the bigger question mark. If you take those, just mention it to your pharmacist or doctor so they can keep an eye on your cholesterol numbers.

References
  1. Roth M, Timmermann BN, Hagenbuch B. Interactions of green tea catechins with organic anion-transporting polypeptides. Drug Metab Dispos 2011;39:920-6. PubMed
  2. Abdelkawy KS, Abdelaziz RM, Abdelmageed AM, Donia AM, El-Khodary NM. Effects of green tea extract on atorvastatin pharmacokinetics in healthy volunteers. Eur J Drug Metab Pharmacokinet. 2020;45(3):351-360. PubMed
  3. Kim TE, Ha N, Kim Y, et al. Effect of epigallocatechin-3-gallate, major ingredient of green tea, on the pharmacokinetics of rosuvastatin in healthy volunteers. Drug Des Devel Ther. 2017;11:1409-1416. PubMed
Minor

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

4 of 4

Atorvastatin Calcium also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Green tea is unlikely to produce clinically significant changes in the levels and clinical effects of CYP3A4 substrates.
In vitro and in vivo research suggests that green tea can inhibit intestinal CYP3A and induce hepatic CYP3A4 enzymes. However, this effect is unlikely to be clinically significant, as green tea does not appear to affect CYP3A4 activity in humans.
Severity Minor Likelihood Unlikely Evidence D

Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Good news here: if you enjoy a cup or two of green tea while taking atorvastatin (Lipitor), the research says you really don't need to worry. Atorvastatin is processed by a liver enzyme called CYP3A4, and green tea can tug on that enzyme a little in lab studies. But in actual people, green tea hasn't been shown to meaningfully change how atorvastatin works.

In theory, slowing that enzyme could let more of the drug build up (think muscle aches or, rarely, liver irritation), while speeding it up could weaken its cholesterol-lowering job. In practice, neither has panned out in humans. This is based on test-tube and animal data only, so I'd consider it very low concern. If you take concentrated green tea extract pills, just give your pharmacist a heads-up.

References
  1. Donovan JL, Chavin KD, Devane CL, et al. Green tea (Camellia sinensis) extract does not alter cytochrome P450 3A4 or 2D6 activity in healthy volunteers. Drug Metab Dispos 2004;32:906-8. PubMed
  2. Nishikawa, M., Ariyoshi, N., Kotani, A., Ishii, I., Nakamura, H., Nakasa, H., Ida, M., Nakamura, H., Kimura, N., Kimura, M., Hasegawa, A., Kusu, F., Ohmori, S., Nakazawa, K., and Kitada, M. Effects of continuous ingestion of green tea or grape seed extrac
  3. Chow, H. H., Hakim, I. A., Vining, D. R., Crowell, J. A., Cordova, C. A., Chew, W. M., Xu, M. J., Hsu, C. H., Ranger-Moore, J., and Alberts, D. S. Effects of repeated green tea catechin administration on human cytochrome P450 activity. Cancer Epidemiol.B PubMed
  4. Engdal, S. and Nilsen, O. G. In vitro inhibition of CYP3A4 by herbal remedies frequently used by cancer patients. Phytother.Res. 2009;23(7):906-912.
  5. Schönthal AH. Adverse effects of concentrated green tea extracts. Mol Nutr Food Res. 2011 Jun;55(6):874-85. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Green Tea Also Interacts With Other Medications

Green Tea has 12 major, 905 moderate, 375 minor known drug interactions in our database — the Atorvastatin Calcium one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Green Tea

Covers the 2,830 medications we’ve checked against Green Tea. Pick one to open its full report.

From our Q&A

Questions About Green Tea or Atorvastatin Calcium

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Green Tea or Atorvastatin Calcium, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Atorvastatin Calcium

This page covers Green Tea only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Atorvastatin Calcium page lists 181 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Apple (major), Beer (major), Grapefruit (major) and Siberian Cocklebur (major).

Open the Atorvastatin Calcium interaction page

One more smart check

Taking Green Tea as Part of a Dietary Supplement Product? Check It for Interactions

We hold 9,084 real supplement products containing Green Tea, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Green Tea. Your product may carry other ingredients that interact with Atorvastatin Calcium too, on top of Green Tea — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Green Tea and Atorvastatin Calcium Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Green Tea
Top 5%

#26 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Atorvastatin Calcium
Top 5%

#101 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Green Tea

What is Green Tea?

Green Tea
  • Antioxidant support
  • Weight loss
  • Heart health
  • Mental alertness
  • Cancer risk reduction

Green tea is a popular beverage rich in antioxidants called catechins, and drinking it in normal amounts is considered safe for most people. Concentrated green tea extracts are a different story—they may help modestly with weight or heart health for some, but high doses have been linked to rare liver problems. Talk to your pharmacist or doctor before taking green tea supplements, especially if you have liver concerns or are pregnant.

Read the full Green Tea monograph & all interactions
Medication

About Atorvastatin

What Is Atorvastatin Used For?

Brand name: Lipitor

Atorvastatin is used alongside a healthy diet to lower LDL ("bad") cholesterol, triglycerides (blood fats), and other harmful lipids, while raising HDL ("good") cholesterol. It treats primary hyperlipidemia (high cholesterol), mixed dyslipidemia (mixed abnormal blood fats), hypertriglyceridemia (high triglycerides), and inherited conditions such as heterozygous and homozygous familial hypercholesterolemia — including in children aged 10 and older.

Beyond cholesterol control, atorvastatin is used to reduce the risk of heart attack, stroke, revascularization procedures, and angina (chest pain) in adults with coronary heart disease or multiple risk factors for it — including adults with type 2 diabetes who have risk factors for heart disease even without a confirmed heart disease diagnosis.

See full Atorvastatin drug information
Keep checking

Other Drugs & Green Tea

Browse every other medication we’ve checked against Green Tea — both the ones with a known interaction and the ones without. Select any drug for the full detail.

12Major
905Moderate
375Minor
1,537No known interaction
Major

12 interactions

Moderate

905 interactions

Showing 60 of 905 moderate interactions — see all 905 on the Green Tea page.

Minor

375 interactions

Showing 60 of 375 minor interactions — see all 375 on the Green Tea page.

No interaction 1,537 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Pharmacist Counseling Corner

Taking Green Tea and Atorvastatin Calcium Together: Common Questions

Can you take Green Tea with Atorvastatin Calcium?
This is rated a major interaction, so the combination is best avoided unless your doctor or pharmacist has specifically told you otherwise. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 4 interactions listed for Green Tea and Atorvastatin Calcium?
Atorvastatin Calcium belongs to more than one drug category, and Green Tea interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Green Tea and Atorvastatin Calcium interaction?
We rate it Major. This is a clinically significant combination that is generally best avoided, or used only under the direct supervision of your physician or pharmacist.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Atorvastatin Calcium and Green Tea?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.