Moderate
Atorvastatin × Dexamethasone
HMG-CoA reductase inhibitors (statins)×Glucocorticoids
Mechanism
Dexamethasone induces CYP3A4. With prolonged therapy, atorvastatin plasma levels may fall modestly and lipid-lowering effect weakens.
Symptoms
The patient feels nothing. Laboratory: LDL cholesterol and total cholesterol rise during prolonged systemic glucocorticoid therapy.
Management
For short dexamethasone courses, no adjustment. For prolonged systemic therapy, monitor lipid profile every 2–3 months; increase atorvastatin by 25–50% if needed.