Minor
Atorvastatin × Azithromycin
HMG-CoA reductase inhibitors (statins)×Macrolides
Mechanism
Azithromycin does not clinically significantly inhibit CYP3A4 (Indiana Flockhart Table). Atorvastatin AUC is unchanged.
Symptoms
The combination usually causes no specific symptoms. Each drug's individual side effects remain.
Management
No dose adjustment needed. When a macrolide is needed in a patient on atorvastatin, azithromycin remains the preferred choice (unlike clarithromycin and erythromycin — strong CYP3A4 inhibitors).