MAJOR — Use With Caution
CAUTION — rosuvastatin is a better choice than atorvastatin/simvastatin during rifampin therapy but still affected
Evidence level: MODERATE
Rifampin reduces rosuvastatin effectiveness, though less severely than other statins.
Rifampin induces multiple CYP enzymes and transporters including OATP1B1. Rosuvastatin levels reduced though less than CYP3A4-dependent statins.
Rosuvastatin or pravastatin are preferred statins during rifampin therapy. Monitor lipid levels.
Some antibiotics (erythromycin, clarithromycin) strongly inhibit CYP3A4 and can dramatically increase statin levels, raising rhabdomyolysis risk. Take Rosuvastatin in the evening as usual. Your prescriber may temporarily pause or reduce the statin during short antibiotic courses.
Cardiovascular disease
Loss of cholesterol control
Discuss which statin is safest during TB treatment.
Statin interactions often involve liver enzyme competition. Ask your doctor about alternative statins (rosuvastatin and pravastatin have fewer CYP interactions) or spacing doses 12 hours apart. CoQ10 supplementation may help with statin-related muscle discomfort.
Rifampin reduces rosuvastatin effectiveness, though less severely than other statins.
Some antibiotics (erythromycin, clarithromycin) strongly inhibit CYP3A4 and can dramatically increase statin levels, raising rhabdomyolysis risk. Take Rosuvastatin in the evening as usual. Your prescriber may temporarily pause or reduce the statin during short antibiotic courses.
Loss of cholesterol control
Statin interactions often involve liver enzyme competition. Ask your doctor about alternative statins (rosuvastatin and pravastatin have fewer CYP interactions) or spacing doses 12 hours apart. CoQ10 supplementation may help with statin-related muscle discomfort.
Discuss which statin is safest during TB treatment.
Or browse the full interaction database (121,000+ pairs).