Minor
Suspected
Descripción
Doxycycline may slightly raise atorvastatin plasma levels through weak inhibition of CYP3A4 and P-glycoprotein, though clinically significant myopathy from this combination is rarely reported.
Mecanismo
Doxycycline has weak inhibitory activity on CYP3A4 and P-gp, which are involved in atorvastatin metabolism and efflux; modest increases in atorvastatin exposure could marginally raise myopathy risk.
Relevancia clínica
There are isolated case reports of statin myopathy with tetracyclines; formal pharmacokinetic studies demonstrating a clinically relevant interaction are lacking.
Manejo clínico
No dose adjustment required; counsel patients on muscle symptoms during antibiotic course; investigate CK elevation if myopathy is suspected.