Compatibility «Equoral» and «Liprimar»

• Interactions Equoral with Liprimar

  • Dangerous interactions
    • ⓘ During treatment with HMG-CoA reductase inhibitors with simultaneous use of cyclosporine, fibrates, nicotinic acid in lipid-lowering doses (more than 1 g/ day) or inhibitors of the CYP3A4 isoenzyme (e.g. erythromycin, clarithromycin, antifungal agents - azole derivatives) increase the risk of myopathy (see 'Special instructions').
    • ⓘ Increases the risk of myopathy and rhabdomyolysis when prescribing lipid-lowering drugs (HMG-CoA reductase inhibitors), impaired renal function - against the background of aminoglycosides, amphotericin B, trimethoprim, co-trimoxazole, ciprofloxacin, some cephalosporins, NSAIDs, propafenone.
    • ⓘ Statin therapy should be temporarily discontinued or discontinued in patients with symptoms of myopathy, as well as in patients with risk factors for severe renal impairment, including renal failure secondary to rhabdomyolysis.
    • ⓘ If necessary, the simultaneous use of cyclosporine and digoxin, colchicine or HMG-CoA reductase inhibitors should be carefully monitored in order to diagnose the toxic effects of these drugs early, followed by a reduction in their dose or complete discontinuation of therapy.
    • ⓘ Cyclosporine (L04AD01) + HMG-CoA reductase inhibitors (C10AA) => Myopathy, muscle weakness. (A dangerous combination, it must be avoided).
  • Negative interactions
    • ⓘ Inhibitors of the CYP3A4 isoenzyme.
    • ⓘ Since atorvastatin is metabolized by the CYP3A4 isoenzyme, the combined use of atorvastatin with inhibitors of the CYP3A4 isoenzyme may lead to an increase in the concentration of atorvastatin in blood plasma.
    • ⓘ It has been found that powerful inhibitors of the CYP3A4 isoenzyme lead to a significant increase in the concentration of atorvastatin in blood plasma.
    • ⓘ If possible, the simultaneous use of potent inhibitors of the CYP3A4 isoenzyme (for example, cyclosporine, telithromycin, clarithromycin, delavirdine, stiripentol, ketoconazole, voriconazole, itraconazole, posaconazole and HIV protease inhibitors, including ritonavir, lopinavir, atazanavir, indinavir, darunavir) should be avoided.
    • ⓘ Moderate inhibitors of the CYP3A4 isoenzyme (e.g. erythromycin, diltiazem, verapamil and fluconazole) may lead to an increase in the concentration of atorvastatin in blood plasma.
    • ⓘ It is known that both amiodarone and verapamil inhibit the activity of the CYP3A4 isoenzyme and the simultaneous use of these drugs with atorvastatin may lead to increased exposure to atorvastatin.
    • ⓘ In this regard, it is recommended to reduce the maximum dose of atorvastatin and conduct appropriate monitoring of the patient's condition while using moderate inhibitors of the CYP3A4 isoenzyme.
    • ⓘ Thus, the combined use of atorvastatin at a dose of 10 mg and cyclosporine at a dose of 5.2 mg / kg / day leads to an increase in the concentration of atorvastatin in blood plasma by 7.7 times (see 'Method of administration and doses').
    • ⓘ With the simultaneous use of atorvastatin and erythromycin (500 mg 4 times a day) or clarithromycin (500 mg 2 times a day), inhibitors of the CYP3A4 isoenzyme, an increase in the concentration of atorvastatin in blood plasma was observed (see 'Special instructions').
    • ⓘ Simultaneous use of atorvastatin with protease inhibitors, known as CYP3A4 isoenzyme inhibitors, is accompanied by an increase in the concentration of atorvastatin in blood plasma.
    • ⓘ Since grapefruit juice contains one or more components that inhibit the CYP3A4 isoenzyme, excessive consumption (more than 1.2 liters per day) can cause an increase in the concentration of atorvastatin in blood plasma.
    • ⓘ The combined use of atorvastatin with inducers of the CYP3A4 isoenzyme (for example, efavirenz, rifampicin or St. John's wort preparations) may lead to a decrease in the concentration of atorvastatin in blood plasma.
    • ⓘ Due to the dual mechanism of interaction with rifampicin (an inducer of the CYP3A4 isoenzyme and an inhibitor of the hepatocyte transport protein OATP1B1), simultaneous use of atorvastatin and rifampicin is recommended, since delayed administration of atorvastatin after taking rifampicin leads to a significant decrease in the concentration of atorvastatin in blood plasma.
    • ⓘ It is possible to interact with simultaneous use of atorvastatin with CYP3A4 inhibitors such as grapefruit juice, some macrolide antibiotics (e.g. erythromycin, clarithromycin), immunosuppressants (cyclosporine), azole antifungal drugs (e.g. itraconazole, ketoconazole), vector inhibitors, HIV and hepatitis C protease inhibitors, letermovir or the antidepressant nefazodone.
    • ⓘ Cyclosporine is an inhibitor of OATP1B1, OATP1B3, multidrug resistance protein (MDR1) and BCRP, as well as CYP3A4, therefore it increases the exposure of atorvastatin.
    • ⓘ Simultaneous use of atorvastatin and CYP3A4 inducers (e.g. efavirenz, rifampicin) may lead to a variable decrease in the concentration of atorvastatin in blood plasma.
    • ⓘ The combined use of atorvastatin at a dose of 10 mg and cyclosporine at a dose of 5.2 mg/kg/day led to an increase in atorvastatin exposure (the ratio of AUC and max'>C_max atorvastatin 8.7 and 10.7, respectively, compared with the use of atorvastatin alone).
    • ⓘ As a result of the dual mechanism of action of rifampicin (induction of CYP3A4 and inhibition of the OATP1B1 transporter), simultaneous co-administration of atorvastatin and rifampicin, etc. is recommended; delayed intake of atorvastatin after administration of rifampicin was associated with a significant decrease in the concentration of atorvastatin in blood plasma.
  • Positive interactions
    • ⓘ The degree of interaction and the potentiation effect are determined by the variability of the effect on the CYP3A4 isoenzyme.
  • Unclear interactions
    • ⓘ OATP1B1 inhibitors (e.g. cyclosporine) may increase the bioavailability of atorvastatin.
    • ⓘ Inducers of the CYP3A4 isoenzyme.
    • ⓘ Cyclosporine may slow the clearance of digoxin, colchicine, prednisolone, HMG‑CoA reductase inhibitors (statins), etoposide, aliskiren, bosentan or dabigatran.
    • ⓘ Atorvastatin is metabolized with the participation of the CYP3A4 isoenzyme.
    • ⓘ Clarithromycin and erythromycin are inhibitors of CYP3A4.
    • ⓘ Cyclosporine.

Decoding the colors of interactions and contraindications

Dangerous	—	a pronounced negative interaction or contraindication.
Negative	—	negative interaction or side effect that may reduce effectiveness.
Positive	—	the interaction can SOMETIMES be used as a positive (often a dose adjustment is needed), or it is an indication.
No	—	the drugs do NOT interact, which is separately indicated in the instructions.
Unclear	—	the system failed to pre-assess the danger.

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Additional information

• Kiberis checks interactions and evaluates drug compatibility for free online right in the instructions thanks to the latest artificial intelligence technologies. The accuracy of finding is more than 95%, the accuracy of the hazard assessment is more than 80%. The online medical service takes into account all the drug groups of the selected drugs and all their components. And since the database contains 25,000 drugs with detailed instructions, not every pharmacologist can compete with our artificial intelligence. List of popular interactions.
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• The use of information about interactions is only possible as an introduction. This information should not be used to adjust therapy without consulting a specialist.
• The article is written: artificial intelligence Kiberis
• Sources: official instructions for medicines and their active substances, as well as inter-group interactions described in medical studies and textbooks.
• Total analyzed: 170,027,037 possible combinations of drugs and their components were found 412,563 interacting combinations.
• Medicine section: Standard evidence-based medicine
• The date of the last update of the interaction database: 2026-01-01

Category - medicine