Moderate
Atorvastatin × Esomeprazole
HMG-CoA reductase inhibitors (statins)×Drugs for peptic ulcer and GORD. Proton pump inhibitors
Mechanism
Esomeprazole weakly affects CYP3A4 (mainly via CYP2C19). Atorvastatin levels are essentially unchanged. DDInter notes rare myalgia.
Symptoms
Usually no changes. Rare muscle pain cases, especially in patients with myopathy risk factors.
Management
The combination is acceptable without dose change. In patients with myopathy risk factors (older age, chronic kidney disease, hypothyroidism), check creatine kinase on muscle symptoms.