Lipitor (atorvastatin) is a brand-name prescription drug used in certain people to:

As with other medications, Lipitor can interact with certain other drugs. It can also interact with some supplements and foods. An interaction occurs when one substance causes another substance to have a different effect than expected.

For details about Lipitor’s interactions, keep reading. For additional information about Lipitor, including details about its uses, see this article.

In some cases, a factor or condition could prevent your doctor from prescribing Lipitor due to the risk of harm. This is known as a contraindication. The contraindications of Lipitor include:

Having liver problems

Lipitor is a type of drug called a statin. Like other statin drugs, Lipitor can harm the liver. There have been rare reports of hospitalizations and fatalities due to liver problems from statin drugs. These drugs include Lipitor.

If you already have a liver problem, taking Lipitor could worsen it. Due to this risk, doctors typically will not prescribe Lipitor if you have a liver problem, such as alcoholic liver disease. You can talk with them about safer treatments for you.

Being pregnant

Statin drugs, such as Lipitor, can cause harm to the fetus if taken during pregnancy. This is due to how they work. Because of this risk, you should not take Lipitor while pregnant. There have not been clinical trials showing whether statins are safe to take during pregnancy.

If you’re pregnant or thinking of becoming pregnant, talk with your doctor.

Breastfeeding

It’s unknown if Lipitor passes into human breast milk or whether the drug causes side effects in a breastfed child. However, due to the risk of serious side effects in the child, you should not breastfeed while taking Lipitor.

Your doctor can advise you on other ways to feed your child during Lipitor treatment.

Having had an allergic reaction to Lipitor or any of its ingredients

If you have had an allergic reaction to Lipitor or any of its ingredients, your doctor will likely not prescribe Lipitor. Taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better choices for you.

Note: Before you start treatment with Lipitor, it’s important to tell your doctor if any of these contraindications apply to you. They can determine whether to prescribe Lipitor.

There’s no known interaction between Lipitor and alcohol. However, both alcohol and Lipitor can cause liver damage. This means that consuming alcohol during Lipitor treatment could increase the risk of this side effect.

If you drink alcohol, talk with your doctor about how much, if any, is safe while you’re taking Lipitor.

Before you start treatment with Lipitor, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Here’s a chart of drugs that can interact with Lipitor. Keep in mind that this chart does not include all drugs that may interact with Lipitor. Some of these interactions are described in detail just below in “Drug interactions in depth.”

Drug class or drug nameDrug examplesInteraction result with Lipitor
certain antivirals and antiretrovirals• Lopinavir/ritonavir (Kaletra)
• elbasvir plus grazoprevir (Zepatier)
• ledipasvir plus sofosbuvir (Harvoni)
can increase the risk of side effects from Lipitor*
certain antifungalsfluconazole (Diflucan)
• itraconazole (Sporanox, Tolsura)
ketoconazole
• voriconazole (Vfend)
• posaconazole (Noxafil)
can increase the risk of side effects from Lipitor*
certain antibioticsclarithromycin
• erythromycin (Eryc)
can increase the risk of side effects from Lipitor*
diltiazem (Cardizem CD)can increase the risk of side effects from Lipitor*
cyclosporine (Gengraf, Neoral)can increase the risk of side effects from Lipitor*
gemfibrozil (Lopid)can increase the risk of side effects from Lipitor*
colchicine (Colcrys, Mitigare)can increase the risk of side effects from Lipitor*
niacincan increase the risk of side effects from Lipitor*

* For information about Lipitor’s side effects, see this article.

Here’s a closer look at certain drug interactions of Lipitor.

Cyclosporine

Cyclosporine (Gengraf, Neoral), a drug commonly prescribed after an organ transplant, can interact with Lipitor.

Interaction result. This interaction can increase the risk of side effects from Lipitor.*

Interaction explained. After you take a dose of Lipitor, your body uses a certain enzyme (protein) to break down the drug. Cyclosporine blocks the action of the enzyme. This causes the level of Lipitor in your body to rise. An increased level of the drug can make side effects from Lipitor more likely to occur.

Steps you or your doctor may take. Due to the increased risk of side effects from Lipitor, doctors typically will not prescribe cyclosporine and Lipitor together. You can talk with your doctor about safer treatment alternatives.

* For information about Lipitor’s side effects, see this article.

Gemfibrozil

Gemfibrozil (Lopid) is a drug prescribed for certain types of high cholesterol or heart disease. It can interact with Lipitor if these drugs are used together.

Interaction result. This interaction can raise your risk of myopathy, which refers to certain muscle side effects, including muscle pain.

Interaction explained. Both Lipitor and gemfibrozil can cause myopathy when taken alone. Taking these drugs together can increase the risk and severity of this condition.

Steps you or your doctor may take. Due to the risk of severe muscle side effects, doctors typically will not prescribe gemfibrozil in combination with Lipitor. Your doctor can suggest other treatment options.

Diltiazem

Diltiazem (Cardizem CD) is a drug used to treat certain heart rhythm problems. It may also be used to lower blood pressure. Diltiazem and Lipitor are known to interact with each other.

Interaction result. This interaction can increase the risk of side effects from Lipitor.*

Interaction explained. After you take a dose of Lipitor, your body uses a certain enzyme to break down the drug. Diltiazem blocks the action of the enzyme. This causes the level of Lipitor in your body to rise. An increased level of the drug can make side effects from Lipitor more likely to occur.

Steps you or your doctor may take. Your doctor can determine whether it’s safe for you to take diltiazem and Lipitor together. If your doctor prescribes both drugs, they’ll likely monitor you closely for side effects, especially muscle-related side effects, such as muscle pain.

* For information about Lipitor’s side effects, see this article.

Lipitor may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below.

Lipitor interactions with supplements

Before you start treatment with Lipitor, tell your doctor and pharmacist which supplements, herbs, and vitamins you take. Sharing this information with them may help prevent possible interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Lipitor interactions with herbs

The herb St. John’s Wort can interact with Lipitor. Specifically, taking St. John’s Wort in combination with Lipitor together may cause Lipitor to be less effective at treating your condition.

After you take a dose of Lipitor, your body uses certain enzymes to break down the drug. St. John’s Wort causes your body to increase the activity of these enzymes. This can speed up how quickly your system gets rid of Lipitor. This may reduce the level of Lipitor in your body, causing the drug to work less well than usual.

If you take St. John’s Wort, be sure to tell your doctor before you begin taking Lipitor. They may prescribe an increased dose of Lipitor. Or they may suggest you stop taking St. John’s Wort or try a drug other than Lipitor.

Lipitor interactions with vitamins

There are no specific reports of vitamins interacting with Lipitor. However, it’s still important to check with your doctor or pharmacist before taking any of these products during Lipitor treatment.

Lipitor interactions with food

You may be wondering if there are certain foods you should not eat or beverages you should not drink while taking Lipitor.

Grapefruit and grapefruit juice can interact with Lipitor when consumed in large quantities. For grapefruit juice, this is more than 1.2 liters per day.

After you take a dose of Lipitor, your body uses a certain enzyme to break down the drug. Grapefruit and grapefruit juice block the action of the enzyme. This causes the level of Lipitor in your body to rise. An increased level of the drug can make side effects from Lipitor more likely to occur.*

Due to this risk, you should avoid consuming large quantities of grapefruit and grapefruit juice during Lipitor treatment.

* For information about Lipitor’s side effects, see this article.

Lipitor and vaccines

Lipitor is not known to interact with any vaccines. Despite this, you should still check with your doctor or pharmacist before receiving any vaccines while taking Lipitor.

Lipitor and lab tests

No lab tests have been reported to interact with Lipitor. However, if you have any lab tests during Lipitor treatment, be sure to tell the healthcare professional that you’re taking the drug.

Lipitor interaction with cannabis or CBD

Cannabis (marijuana) and cannabis products, such as cannabidiol (CBD), have been specifically reported to interact with Lipitor. Specifically, cannabis may raise or lower the level of Lipitor in your body. If the level decreases, this can cause the drug to be less effective or not work at all. If the Lipitor level rises, you may be at an increased risk of side effects from the drug. (For information about Lipitor’s side effects, see this article.)

Before you start treatment with Lipitor, tell your doctor and pharmacist if you take cannabis. By sharing this information with them, you may help prevent possible interactions.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Certain medical conditions and other factors may increase the risk of interactions with Lipitor. Before you take Lipitor, be sure to talk with your doctor about your health history. Lipitor may not be the right treatment option for you if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Lipitor include:

  • Pregnancy. Lipitor is not safe to take while pregnant.*
  • Breastfeeding. Lipitor is not safe to take while breastfeeding.*
  • Allergic reaction. If you’ve had an allergic reaction to Lipitor or any of its ingredients, your doctor will likely not prescribe Lipitor.*
  • Liver problems. Doctors usually will not prescribe Lipitor if you have a liver problem, such as alcoholic liver disease.*
  • Kidney problems. If you have a kidney problem, such as chronic kidney disease, it’s usually safe to take Lipitor. However, kidney problems can increase the risk of myopathy with the drug. Your doctor will likely monitor you closely for side effects if they prescribe Lipitor.†
  • Hypothyroidism. If you have hypothyroidism, it’s usually safe to take Lipitor. However, if the condition is not managed, your risk of myopathy with Lipitor can increase. Be sure to tell your doctor if you have hypothyroidism that is not being treated. They’ll likely prescribe a treatment to raise your thyroid hormone levels before you start taking Lipitor.

* For more information, see “When to avoid Lipitor” above.
† For information about Lipitor’s side effects, see this article.

Here are some frequently asked questions about Lipitor and possible interactions.

Does Viagra interact with Lipitor?

No, sildenafil (Viagra) has not been reported to interact with Lipitor. In fact, Viagra and Lipitor are sometimes used in combination with each other.

Viagra is used to treat erectile dysfunction (ED), which is a common condition in people with heart disease. And Lipitor is approved to decrease the risk of cardiovascular problems in some people with heart disease.

If you have additional questions about Viagra and Lipitor, talk with your doctor or pharmacist.

Are there interactions between Lipitor and nutrients such as CoQ10?

No, Lipitor is not known to interact with coenzyme Q10 (CoQ10). It’s thought that CoQ10 supplements and Lipitor are safe to take together.

CoQ10 is a chemical that exists naturally in the body. It has several functions, including energy production and antioxidant effects. Statin drugs such as Lipitor can lower the level of CoQ10 in the body. This may increase the risk of certain side effects from the statin drug, such as muscle pain.

Some studies have suggested that taking a CoQ10 supplement can help ease muscle side effects from statin drugs such as Lipitor. However, other studies have found no evidence that CoQ10 relieves muscle side effects from statins.

If you’d like to learn more about taking a CoQ10 supplement with Lipitor, talk with your doctor or pharmacist.

Does Zetia interact with Lipitor?

No. Ezetimibe (Zetia) is not known to interact with Lipitor. It’s believed that these drugs are safe to take together.

Zetia is actually approved to be used with statin drugs such as Lipitor to lower cholesterol in certain adults.

For more information about taking Zetia with Lipitor, talk with your doctor or pharmacist.

Is it safe to take metformin with Lipitor?

Yes, it’s thought that metformin (Glumetza, Fortamet) and Lipitor are safe to take together. There have not been reports of drug interactions between these medications.

Metformin is used to manage blood sugar levels in people with type 2 diabetes. It’s common for people to have both heart disease and type 2 diabetes. So, it’s not unusual for these medications to be prescribed together.

Your doctor or pharmacist can tell you more about taking metformin with Lipitor.

Can I take aspirin with Lipitor?

Yes. It’s believed that aspirin is safe to take with Lipitor. There are no known interactions between these drugs.

It’s actually common for people to be prescribed both aspirin and Lipitor. Aspirin is often used in certain adults who have heart disease. And Lipitor is approved to decrease the risk of cardiovascular problems in some people with heart disease.

If you’d like to learn more about taking aspirin during Lipitor treatment, talk with your doctor or pharmacist.

You can take certain steps to help prevent interactions with Lipitor. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan the following:

  • Let them know if you drink alcohol or take cannabis.
  • Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
  • Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the label of Lipitor and other paperwork that comes with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the prescribing information, may contain details about interactions. If this information is difficult to understand, ask your doctor or pharmacist to help explain it.

You can also help prevent interactions with Lipitor by taking it exactly as your doctor prescribes.

Besides learning about interactions, you may want to find out more about Lipitor. These resources might help:

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.