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Does Lipitor Interact With Ciproflaxin?

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Posted on Thu, 4 Feb 2016
Question: Can I take Lipitor 10 mg with ciproflaxin HCL 500 mg. I have only been taking Lipitor for one week. I have a UTi and I have some ciproflaxin on hand.
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Answered by Dr. Bonnie Berger-Durnbaugh (44 minutes later)
Brief Answer:
"Moderate Interaction"

Detailed Answer:
Hello and welcome,

I ran a check of Cipro with Lipitor (atorvastatin) and the results said there is moderate interaction between the two. This is not a complete contraindication, but is a concern. The problem is that Cipro inhibits the liver enzyme that metabolizes (processes and breaks down) Lipitor. This means that when ciprofloxin is in your system, it can raise the amount of Lipitor in your system, which will not be broken down at the usual rate. So the possibility of Lipitor side effects (liver and muscle problems) is greater. Again, it's not an absolute contraindication, but may not be the best combination.

Another thing to consider: If you start the Cipro before giving a urine specimen to be sent for "culture and sensitivity", there is the possibility the bacteria in the urine may be resistant or partially resistant to Cipro, and if the Cipro is only partially effective, a subsequent urinalysis may not be helpful. So you won't know what you are dealing with and what antibiotic is best. I like to have people give a urine specimen and send it for both culture (growth and identification of the bacteria) and sensitivity (a test of which antibiotics will work against it).

Possibly you could go in to your doctor or urgent care tomorrow? In the meantime take lots of cranberry and cranberry juice.

For your reference, I am copying below the information about the interaction between Cipro and Lipitor:

--------------------------

Interactions between your selected drugs
Moderate
ciprofloxacin atorvastatin
Applies to: Cipro (ciprofloxacin), Lipitor (atorvastatin)

MONITOR: Coadministration with inhibitors of CYP450 3A4 may increase the plasma concentrations of HMG-CoA reductase inhibitors (i.e., statins) that are metabolized by the isoenzyme. Lovastatin and simvastatin are particularly susceptible because of their low oral bioavailability, but others such as atorvastatin and cerivastatin may also be affected. High levels of HMG-CoA reductase inhibitory activity in plasma is associated with an increased risk of musculoskeletal toxicity. Myopathy manifested as muscle pain and/or weakness associated with grossly elevated creatine kinase exceeding ten times the upper limit of normal has been reported occasionally. Rhabdomyolysis has also occurred rarely, which may be accompanied by acute renal failure secondary to myoglobinuria and may result in death. Clinically significant interactions have been reported with potent CYP450 3A4 inhibitors such as macrolide antibiotics, azole antifungals, protease inhibitors and nefazodone, and moderate inhibitors such as amiodarone, cyclosporine, danazol, diltiazem and verapamil.

MANAGEMENT: Caution is recommended if atorvastatin, cerivastatin, lovastatin, simvastatin, or red yeast rice (which contains lovastatin) is prescribed with a CYP450 3A4 inhibitor. It is advisable to monitor lipid levels and use the lowest effective statin dose. All patients receiving statin therapy should be advised to promptly report any unexplained muscle pain, tenderness or weakness, particularly if accompanied by fever, malaise and/or dark colored urine. Therapy should be discontinued if creatine kinase is markedly elevated in the absence of strenuous exercise or if myopathy is otherwise suspected or diagnosed. Fluvastatin, pravastatin, and rosuvastatin are not expected to interact with CYP450 3A4 inhibitors.
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Bonnie Berger-Durnbaugh

General & Family Physician

Practicing since :1991

Answered : 3134 Questions

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Does Lipitor Interact With Ciproflaxin?

Brief Answer: "Moderate Interaction" Detailed Answer: Hello and welcome, I ran a check of Cipro with Lipitor (atorvastatin) and the results said there is moderate interaction between the two. This is not a complete contraindication, but is a concern. The problem is that Cipro inhibits the liver enzyme that metabolizes (processes and breaks down) Lipitor. This means that when ciprofloxin is in your system, it can raise the amount of Lipitor in your system, which will not be broken down at the usual rate. So the possibility of Lipitor side effects (liver and muscle problems) is greater. Again, it's not an absolute contraindication, but may not be the best combination. Another thing to consider: If you start the Cipro before giving a urine specimen to be sent for "culture and sensitivity", there is the possibility the bacteria in the urine may be resistant or partially resistant to Cipro, and if the Cipro is only partially effective, a subsequent urinalysis may not be helpful. So you won't know what you are dealing with and what antibiotic is best. I like to have people give a urine specimen and send it for both culture (growth and identification of the bacteria) and sensitivity (a test of which antibiotics will work against it). Possibly you could go in to your doctor or urgent care tomorrow? In the meantime take lots of cranberry and cranberry juice. For your reference, I am copying below the information about the interaction between Cipro and Lipitor: -------------------------- Interactions between your selected drugs Moderate ciprofloxacin atorvastatin Applies to: Cipro (ciprofloxacin), Lipitor (atorvastatin) MONITOR: Coadministration with inhibitors of CYP450 3A4 may increase the plasma concentrations of HMG-CoA reductase inhibitors (i.e., statins) that are metabolized by the isoenzyme. Lovastatin and simvastatin are particularly susceptible because of their low oral bioavailability, but others such as atorvastatin and cerivastatin may also be affected. High levels of HMG-CoA reductase inhibitory activity in plasma is associated with an increased risk of musculoskeletal toxicity. Myopathy manifested as muscle pain and/or weakness associated with grossly elevated creatine kinase exceeding ten times the upper limit of normal has been reported occasionally. Rhabdomyolysis has also occurred rarely, which may be accompanied by acute renal failure secondary to myoglobinuria and may result in death. Clinically significant interactions have been reported with potent CYP450 3A4 inhibitors such as macrolide antibiotics, azole antifungals, protease inhibitors and nefazodone, and moderate inhibitors such as amiodarone, cyclosporine, danazol, diltiazem and verapamil. MANAGEMENT: Caution is recommended if atorvastatin, cerivastatin, lovastatin, simvastatin, or red yeast rice (which contains lovastatin) is prescribed with a CYP450 3A4 inhibitor. It is advisable to monitor lipid levels and use the lowest effective statin dose. All patients receiving statin therapy should be advised to promptly report any unexplained muscle pain, tenderness or weakness, particularly if accompanied by fever, malaise and/or dark colored urine. Therapy should be discontinued if creatine kinase is markedly elevated in the absence of strenuous exercise or if myopathy is otherwise suspected or diagnosed. Fluvastatin, pravastatin, and rosuvastatin are not expected to interact with CYP450 3A4 inhibitors.