Can I take Atorvastatin and Rivaroxaban together?

Why this happens

Both medications are processed by the same enzyme system in the liver (CYP3A4) and a transport protein (P-gp). Because they compete for these systems, atorvastatin can slow down the breakdown of rivaroxaban, leading to slightly higher levels of the blood thinner in your body.

It is generally safe to take these two medicines together, as the interaction is usually mild. However, you should be vigilant for any signs of unusual bleeding or bruising. If you notice blood in your urine, black tarry stools, or a nosebleed that won't stop, contact your doctor immediately. Ensure your doctor knows you are taking both, especially if your dose of atorvastatin is increased.

Pregnancy

You must not take atorvastatin if you are pregnant or planning to become pregnant, as it can cause serious harm to an unborn baby. Use effective contraception while taking this medicine.

Muscle disorders - atorvastatin

Seek immediate medical advice if you experience unexplained muscle pain, tenderness, or weakness. In rare cases, this can lead to a serious condition called rhabdomyolysis which causes kidney damage.

Active bleeding or high bleeding risk

Rivaroxaban significantly increases your risk of serious bleeding. You must seek immediate medical help if you have a fall or head injury, or if you notice signs of internal bleeding such as black tarry stools or coughing up blood.

Grapefruit juice

Grapefruit juice contains compounds that can increase the level of atorvastatin in your blood. This may increase your risk of side effects, such as muscle pain or damage. Avoid drinking large quantities (more than 1.2 litres per day), though it is safest to avoid it altogether or keep intake to very small amounts.

Alcohol

While there is no direct interaction, drinking large amounts of alcohol can increase the risk of liver problems with atorvastatin and increase the risk of stomach bleeding with rivaroxaban. It is best to stick to the recommended daily limits.

Food (General) - rivaroxaban

The 15mg and 20mg tablets must be taken with food to ensure the medicine is absorbed properly into your body. If taken on an empty stomach, the medicine may not work as well. The 2.5mg and 10mg doses can be taken with or without food.

Taking multiple medicines? Our Medicines Interaction Checker helps you check whether your prescriptions, over-the-counter medicines, and supplements are safe to take together. Simply search for your medicines to see potential interactions and what to do about them.

Disclaimer

This information is for general educational purposes only and should not be relied upon as a substitute for professional medical advice. Always consult your GP, pharmacist, or another qualified healthcare professional before making decisions about your medications. Individual circumstances may vary, and only a healthcare professional who knows your medical history can provide personalised guidance.