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CYP2C19 Inhibitos: Clopidogl is mtabolizd tits activ mtabolit in pat by CYP2C19. Concomitant us ctain dugs that inhibit th activity this nzym sults in ducd plasma concntations th activ mtabolit clopidogl and a duction in platlt inhibition. Th blood pressure medication cozaar generic clinical lvanc this intaction is unctain. As a pcaution concomitant us stong modat CYP2C19 inhibitos should b discouagd. Mdicinal poducts that a stong modat CYP2C19 inhibitos includ xampl, ompazol and sompazol, luvoxamin, luoxtin, moclobmid, voiconazol, luconazol, ticlopidin, cabamazpin, and avinz.

Th isk myopathy duing tatmnt with dugs in this class is incasd with concunt administation cyclospoin, ibic acid divativs, ythomycin, claithomycin, th hpatitis C potas inhibittlapvi, combinations HIV potas inhibitos, including saquinavi plus itonavi, lopinavi plus itonavi, tipanavi plus itonavi, daunavi plus itonavi, osampnavi, and osampnavi plus itonavi, niacin, azol antiungals. Physicians considing combind thapy with ATOLIP CV and ibic acid divativs, ythomycin, claithomycin, a combination itonavi plus saquinavi, lopinavi plus itonavi, daunavi plus itonavi, osampnavi, osampnavi plus itonavi, azol antiungals, lipid-modiying doss niacin should caully wigh th potntial bnits and isks and should caully monitpatints any signs symptoms muscl pain, tndnss, waknss, paticulaly duing th initial months thapy and duing any piods upwad dosag titation ith dug. Low stating and maintnanc doss ATOLIP CV should b considd whn takn concomitantly with th aomntiond dugs. Piodic CPK dtminations may b considd in such situations, but th is nassuanc that such monitoing will pvnt th occunc sv myopathy.

Th hav bn a pots immun-mdiatd ncotizing myopathy (IMNM), an autoimmun myopathy, associatd with statin us. IMNM is chaactizd by: poximal muscl waknss and lvatd sum catin kinas, which psist dspit discontinuation statin tatmnt; muscl biopsy showing ncotizing myopathy without signiicant inlammation; impovmnt with immunosuppssiv agnts.

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atorlip-ez ezetimibe had no clinically meaningful effect on the plasma concentrations of the fat-soluble vitamins a, d, and e in a study of 113 patients , and did not impair adrenocortical steroid hormone production in a study of 118 patients .

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