Minor
Suspected
Description
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.
Mécanisme
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.
Signification clinique
There are isolated case reports of statin myopathy with tetracyclines; formal pharmacokinetic studies demonstrating a clinically relevant interaction are lacking.
Prise en charge
No dose adjustment required; counsel patients on muscle symptoms during antibiotic course; investigate CK elevation if myopathy is suspected.