Lipitor (atorvastatin) is a prescription drug used to treat high cholesterol and to lower certain risks. The drug can interact with certain foods, other medications, and some supplements. For example, Lipitor can interact with grapefruit.

Lipitor is used along with diet and exercise to:

  • treat high cholesterol in certain adults and some children
  • lower cardiovascular-related risks such as heart attack or stroke in certain adults
  • lower the need for certain heart surgeries in certain adults

An interaction can occur because one substance causes another substance to have a different effect than expected. Interactions can also occur if you have certain health conditions.

Lipitor contains the active ingredient atorvastatin. (An active ingredient is what makes a drug work.) Lipitor comes as an oral tablet.

Keep reading to learn about Lipitor’s possible interactions, including what you shouldn’t eat or drink while taking Lipitor. And for more information about Lipitor, including details about its uses, see this article.

Certain health conditions or other factors could raise your risk of harm if you take Lipitor. In such cases, your doctor may not prescribe Lipitor for you. These are known as contraindications. The list below includes contraindications of Lipitor.

If you have certain liver problems: Your doctor typically will not prescribe Lipitor if you’re experiencing acute (sudden) liver failure or have decompensated cirrhosis. Taking a statin drug such as Lipitor may worsen your condition. Instead, your doctor can recommend a safer treatment option for your condition.

If you’ve had an allergic reaction: If you’ve had an allergic reaction to Lipitor or any of its ingredients, your doctor likely won’t prescribe Lipitor. This is because taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better options for you.

Before you start taking Lipitor, talk with your doctor if any of the factors above apply to you. Your doctor can determine whether Lipitor is safe for you to take.

There aren’t any known interactions between Lipitor and alcohol. But your doctor may recommend limiting the amount of alcohol you drink while taking Lipitor. Both Lipitor and alcohol can raise your risk of liver problems. So you may be more likely to experience liver problems if you drink alcohol during your Lipitor treatment.

If you have questions about consuming alcohol while taking Lipitor, talk with your doctor or pharmacist.

Before you start taking Lipitor, tell your doctor and pharmacist about any prescription, over-the-counter, or other drugs you take. Sharing this information with them may help prevent possible interactions.

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

The chart below lists drugs that may interact with Lipitor. Keep in mind that this chart does not include all drugs that may interact with Lipitor. For more information about some of these interactions, see the “Drug interactions explained” section below.

Drug group or drug nameDrug examplesWhat can happen
cyclosporine (Neoral, Gengraf)­—can raise the risk of side effects from Lipitor
antiviral medications• glecaprevir/pibrentasvir (Mavyret)
• fosamprenavir
• elbasvir/grazoprevir (Zepatier)
• letermovir (Prevymis)
• lopinavir/ritonavir (Kaletra)
can raise the risk of side effects from Lipitor
certain antibioticsclarithromycin
• erythromycin (Eryc)
• ciprofloxacin (Cipro)
can increase the risk of side effects from Lipitor
certain antifungals• itraconazole (Sporanox)
ketoconazole
fluconazole (Diflucan)
can increase the risk of side effects from Lipitor
fibratesfenofibrate (Tricor)
gemfibrozil (Lopid)
can raise the risk of side effects from Lipitor
niacin (Niacor)can increase the risk of side effects from Lipitor
colchicine (Colcrys)can increase the risk of side effects from Lipitor
birth control pills• desogestrel/ethinyl estradiol (Enskyce, Kariva)
• drospirenone/ethinyl estradiol (Loryna, Yaz)
• ethinyl estradiol/norethindrone (Junel, Balziva)
can increase the risk of side effects from birth control pills
digoxin (Lanoxin)can raise the risk of side effects from digoxin
rifampin (Rimactane)can make Lipitor less effective
diltiazem (Cartia XT)can increase the risk of side effects from Lipitor
certain seizure medicationscarbamazepine (Tegretol)
oxcarbazepine (Trileptal)
can make Lipitor less effective
leflunomide (Arava)can raise the risk of side effects from Lipitor
nefazodonecan increase the risk of side effects from Lipitor

Learn more about certain drug interactions that can occur with Lipitor.

Interaction with diltiazem (Cartia XT)

Lipitor may interact with a blood pressure drug called diltiazem (Cartia XT, others). Diltiazem belongs to a group of drugs called calcium channel blockers.

What could happen

Taking diltiazem with Lipitor can increase your risk of side effects from Lipitor. This is because diltiazem can block your body’s ability to break down Lipitor. This can raise your risk of side effects, including serious side effects such as myopathy (muscle pain), rhabdomyolysis (muscle breakdown), and liver problems.

What you can do

If you already take diltiazem, tell your doctor before starting your Lipitor treatment. Your doctor may recommend monitoring you more closely for symptoms of myopathy, rhabdomyolysis, and liver problems during your treatment. In some cases, they may prescribe a lower dose of Lipitor for you.

If you have questions about taking Lipitor with diltiazem, talk with your doctor.

Interaction with certain antifungal drugs

Lipitor can interact with a certain type of antifungal drug called azole antifungals.

Examples of azole antifungal medications include:

What could happen

Taking Lipitor with certain antifungal medications may raise your risk of side effects from Lipitor. Azole antifungals can decrease your body’s ability to break down Lipitor. This can cause Lipitor to build up in your body, which can raise your risk of side effects. In some cases, side effects may be serious, such as myopathy, rhabdomyolysis, and liver problems.

What you can do

If you need to take an antifungal drug during your Lipitor treatment, talk with your doctor first. In some cases, they may be able to recommend specific antifungal treatments that don’t interact with Lipitor.

If you need to take an azole antifungal with Lipitor, your doctor may monitor you more closely for symptoms of side effects such as myopathy, rhabdomyolysis, and liver problems. Or your doctor may lower your Lipitor dose.

Interaction with birth control pills

Lipitor may interact with certain birth control pills. Examples include:

  • desogestrel/ethinyl estradiol (Enskyce, Kariva)
  • drospirenone/ethinyl estradiol (Loryna, Yaz)
  • ethinyl estradiol/norethindrone (Junel, Balziva)

What could happen

Taking birth control pills with Lipitor may raise your risk of side effects from your birth control pills. This is because Lipitor can increase birth control hormone levels in your blood. This may raise your risk of side effects from your birth control pills.

What you can do

If you want to take Lipitor with birth control pills, talk with your doctor first. They may monitor you more closely for side effects from your birth control pills.

If you do experience more side effects than usual, your doctor may recommend a different birth control option for you. For example, a vaginal ring such as etonogestrel ethinyl estradiol (NuvaRing) or a contraceptive injection such as medroxyprogesterone (Depo-Provera) may be better options.

If you have questions about using Lipitor with birth control pills, talk with your doctor.

Lipitor may have other interactions. They could occur with foods, supplements, vaccines, or even lab tests. See below for details. Note that the information below does not include all other possible interactions with Lipitor.

Does Lipitor interact with food?

You should avoid grapefruit and grapefruit juice during your Lipitor treatment. Grapefruit and grapefruit juice can block your body’s ability to break down Lipitor. This can cause a buildup of Lipitor in your body, which raises your risk of side effects. In some cases, these side effects may be serious, such as myopathy (muscle pain), rhabdomyolysis (muscle breakdown), and liver problems.

Does Lipitor interact with supplements?

Before you start taking Lipitor, talk with your doctor and pharmacist about any supplements, herbs, and vitamins you take. Sharing this information with them may help you avoid possible interactions.

Your doctor may recommend avoiding red yeast rice when you’re taking Lipitor. Red yeast rice and Lipitor work in similar ways to lower cholesterol levels. So taking the two together may increase your risk of side effects such as myopathy, rhabdomyolysis, and liver problems.

Be sure to talk with your doctor about any supplements you take along with Lipitor. They can determine if they may be safe to take during your Lipitor treatment.

If you have questions about interactions that may affect you, talk with your doctor or pharmacist.

Lipitor interactions with herbs

Lipitor can interact with St. John’s wort. This herbal supplement can be used to help lower symptoms of depression.

St. John’s wort can cause your body to break down Lipitor too quickly, which can make Lipitor less effective. If you take St. John’s wort, your doctor may recommend that you stop taking it during your Lipitor treatment.

Lipitor and vitamins

There are currently no reports of Lipitor interacting with vitamins. But this doesn’t mean that vitamin interactions won’t be recognized in the future.

For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products while taking Lipitor.

Does Lipitor interact with vaccines?

No, Lipitor isn’t known to interact with any vaccines. If you have questions about getting specific vaccines during your Lipitor treatment, talk with your doctor or pharmacist.

Does Lipitor interact with lab tests?

No, Lipitor isn’t known to interact with lab tests. But if you need to have lab tests, make sure the healthcare professional giving you the test knows about all medications you currently take. They can make sure there won’t be any interactions between your lab tests and medications.

Does Lipitor interact with cannabis or CBD?

Cannabis (commonly called marijuana) and cannabis products, such as cannabidiol (CBD), have been specifically reported to interact with Lipitor. It’s possible for cannabis to either increase or decrease the amount of Lipitor in your blood. This may increase your risk of side effects, including myopathy (muscle pain), rhabdomyolysis (muscle breakdown), and liver problems. Sometimes, this interaction can cause Lipitor to be less effective.

Before you start treatment with Lipitor, tell your doctor and pharmacist if you use 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 or other health factors may raise the risk of interactions with Lipitor. Before taking Lipitor, talk with your doctor about your health history. They’ll determine whether Lipitor is right for you.

Health conditions or other factors that might interact with Lipitor include:

Liver problems: If you have any liver problems, tell your doctor before taking Lipitor. This drug may cause liver problems. And if you already have a liver condition, taking Lipitor may make it worse. Due to this risk, if you have certain liver problems, your doctor will likely recommend that you take a different medication for your cholesterol.

Kidney problems: Before starting treatment with Lipitor, tell your doctor about any kidney problems you have. Lipitor can cause serious side effects, such as myopathy or rhabdomyolysis. If you have kidney problems, you may have a higher risk of these side effects from Lipitor. If you have kidney problems and take Lipitor, your doctor may monitor you more closely for side effects during your treatment.

Diabetes: In rare cases, Lipitor can raise your risk of high blood sugar. If you have diabetes, taking Lipitor can make your condition worse. Your doctor may recommend monitoring your blood sugar levels more often during your Lipitor treatment.

Stroke: Before taking Lipitor, tell your doctor if you’ve recently had a hemorrhagic stroke. In rare cases, taking a high dose of Lipitor can increase your risk of having another stroke. Your doctor can determine whether Lipitor may be safe for you. If they decide the drug is safe for you to take, they’ll prescribe a Lipitor dosage that’s right for you.

Underactive thyroid: If you have an underactive thyroid, you may have a higher risk of myopathy and rhabdomyolysis while taking Lipitor. If you have an underactive thyroid, talk with your doctor before taking Lipitor. They may monitor you more closely during your treatment, or they may prescribe treatment for your thyroid condition.

Pregnancy: Talk with your doctor about whether you should take Lipitor during pregnancy. Based on how the drug works, it’s possible that Lipitor could cause problems with fetal development (commonly called birth defects). But studies over decades of pregnant people taking statin drugs, such as Lipitor, haven’t shown a higher risk of this effect. Still, due to these possible risks, your doctor will likely recommend a different treatment if you’re pregnant or planning a pregnancy.

Breastfeeding: Your doctor will likely recommend that you do not take Lipitor while you’re breastfeeding. At this time, it’s not known whether the drug passes into breast milk or what effects it may have on a child who’s breastfed. If you’re breastfeeding or planning to breastfeed, talk with your doctor about your treatment options.

Allergic reaction: If you’ve had an allergic reaction to Lipitor or any of its ingredients, your doctor will likely not prescribe Lipitor. This is because taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.

Find answers to some frequently asked questions about Lipitor and possible interactions.

Is it safe to take Lipitor with nonsteroidal anti-inflammatory drugs (NSAIDs)?

Yes, it’s likely safe to take Lipitor along with NSAIDs. There aren’t any known interactions between these drugs. NSAIDs are used to treat pain, swelling, or fever. Examples of NSAIDs include:

If you have questions about taking NSAIDs with Lipitor, talk with your doctor or pharmacist.

Can Lipitor be taken along with ezetimibe (Zetia) to treat my high cholesterol?

Yes, it’s likely safe to take ezetimibe (Zetia) with Lipitor. There aren’t any known interactions between the two drugs.

Both Lipitor and Zetia are approved to treat high cholesterol. And in some cases, taking Zetia with statin drugs such as Lipitor is recommended to treat high cholesterol.

Before you start treatment for high cholesterol, your doctor will recommend the best plan for you. In some cases, they may recommend taking Zetia and Lipitor together.

Are there interactions between Lipitor and caffeine?

It’s likely safe for you to have caffeine along with Lipitor. There aren’t any known interactions between Lipitor and caffeine. Caffeine is present in certain foods and drinks, such as coffee, chocolate, and tea.

If you’d like to have caffeine while you’re taking Lipitor, talk with your doctor. They can determine how much caffeine may be safe during your treatment.

Does Lipitor interact with lisinopril (Zestril)?

No, there aren’t any known interactions between Lipitor and lisinopril (Zestril). It’s likely safe for you to take these medications together.

Lisinopril is used to lower blood pressure in people with high blood pressure. In some cases, your doctor may recommend taking Lipitor with lisinopril.

Does Lipitor interact with the nutrient CoQ10?

No, there aren’t any known interactions between Lipitor and the nutrient CoQ10. This is an antioxidant that’s found in your body. It helps improve energy and protects your body from damage.

Statin drugs such as Lipitor may actually decrease the amount of CoQ10 in your body. This can increase your risk of certain side effects from Lipitor, such as myopathy (muscle pain) and rhabdomyolysis (muscle breakdown).

Taking CoQ10 supplements along with Lipitor may lower your risk of these side effects. But more research is needed to determine whether CoQ10 may be effective for this use. Talk with your doctor to see if they may recommend taking CoQ10 supplements along with Lipitor.

Is it safe for me to take Lipitor with sildenafil (Viagra)?

Yes, it’s likely safe to take Lipitor and sildenafil (Viagra) together. There aren’t any known interactions between these drugs. Viagra is used to treat erectile dysfunction.

But before you start taking Viagra, be sure to tell your doctor about any other drugs you take. This can help prevent interactions between Viagra and your other medications.

Taking certain steps can help you avoid interactions with Lipitor. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:

  • Whether you drink alcohol or use cannabis.
  • Other medications you take, as well as any vitamins, supplements, and herbs. Your doctor or pharmacist can help you fill out a medication list.
  • What to do if you start taking a new drug during your Lipitor treatment.

It’s also important to read Lipitor’s label and other paperwork that may come with the drug. You may see colored stickers on the label that describe interactions. And the paperwork (sometimes called the patient package insert or medication guide) may have other details about interactions. (If you did not get paperwork with Lipitor, ask your pharmacist to print a copy for you.) If you need help understanding this information, your doctor or pharmacist can help.

Taking Lipitor exactly as prescribed can also help prevent interactions.

If you still have questions about Lipitor and its possible interactions, talk with your doctor.

Questions you may want to ask them include:

  • Do other drugs that treat my condition also have similar interactions?
  • Should I let you know if I start taking other medications or supplements during my Lipitor treatment?
  • Does my risk of interactions depend on my Lipitor dosage?
  • Would spacing out my medications lower my risk of interactions?

To learn more about Lipitor, see these articles:

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Disclaimer: Healthline 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.