Moderate
Atorvastatin × Ciprofloxacin
HMG-CoA reductase inhibitors (statins)×Fluoroquinolone antibacterials
Mechanism
Ciprofloxacin is a weak CYP3A4 inhibitor. Atorvastatin plasma levels may rise slightly during short ciprofloxacin courses.
Symptoms
Usually no changes. In patients with myopathy risk factors: rare muscle pain.
Management
For short ciprofloxacin courses (5–7 days), no special adjustment. In patients with myopathy risk factors, check creatine kinase on muscle symptoms.