NutriStack
Atorvastatin and Clarithromycin, a caution.
Clarithromycin inhibits CYP3A4, increasing atorvastatin levels. While less dramatic than simvastatin interaction (atorvastatin is partially CYP3A4 metabolized), the risk of myopathy and rhabdomyolysis is still significantly elevated.
One pair, every claim cited. The two substances, the type, the mechanism, the recommendation, and the primary literature.
Same shape as the other 1,729 pairs in the public database.
From the interaction database
What the row says.
Every entry follows the same shape: what is happening, the mechanism, the recommendation, and the primary literature.
At a glance
- Substances
- Atorvastatin and Clarithromycin
- Pair type
- Caution
- Evidence (highest tier)
- Strong
- Source citations
- 1 source
- Stack Score effect
- −5 to your Stack Score (per scored caution row).
- Scope
- Supplement × Prescription
- Last verified
- May 30, 2026
Caution · Strong evidence
Caution
What is happening. Clarithromycin inhibits CYP3A4, increasing atorvastatin levels. While less dramatic than simvastatin interaction (atorvastatin is partially CYP3A4 metabolized), the risk of myopathy and rhabdomyolysis is still significantly elevated.
Mechanism. CYP3A4 inhibition by clarithromycin reduces atorvastatin first-pass metabolism, increasing systemic exposure and myotoxicity risk.
Recommendation. Limit atorvastatin to 20 mg daily when used with clarithromycin. Consider azithromycin as alternative macrolide (no CYP3A4 inhibition) or pravastatin/rosuvastatin as alternative statin.
Sources (1)
Stack Score
How this pair moves the number.
Effect on the composite score
If both Atorvastatin and Clarithromycin are in the same stack, this pair applies −5 to your Stack Score (per scored caution row).
The full algorithm, the clamping rules, and four worked stacks are documented at /methodology/stack-score.
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