Q: I am currently taking a statin Storvas 10 mg to control high cholesterol. I was recently prescribed an antibiotic Zithromax for 6 days for cold and fever. Please advise if there is any contraindication in the drugs if I continue to take the statin whilst on the antibiotic?

A:Storvas is the brand name; it contains atorvastatin. Zithromax contains azithromycin and belongs to the macrolide class. It is known that some macrolides such as erythromycin, troleandomycin and clarithromycin increase the blood levels of atorvastatin (Storvas) by about 33% and hence increase the risk of myopathy (muscle injury that can be serious). It is also known that azithromycin interacts with lovastatin (another statin) and can cause acute muscle injury (rhabdomyolysis). However the interaction between azithromycin and atorvastatin has not been studied. Under the circumstances, azithromycin should be avoided unless no other antibacterial is effective. Incidentally for cold with/without fever no antibiotic will work since it is a viral infection. Only paracetamol (acetaminophen) should be adequate.