Coadministration of atorvastatin (20 mg single dose) and grazoprevir (200 mg once daily) increased atorvastatin AUC and Cmax by 3.00- and 5.66-fold (primarily due to BCRP inhibition). Grazoprevir AUC, Cmax and C24 increased by 26%, 26% and 11%, respectively. Coadministration of atorvastatin (10 mg single dose) and elbasvir/grazoprevir (50/200 mg once daily) increased atorvastatin AUC and Cmax by 94% and 334% but decreased C24 by 79%. The dose of atorvastatin should not exceed a daily dose of 20 mg when co-administered with elbasvir/grazoprevir.

Coadministration of elbasvir and grazoprevir with atorvastatin increases the concentrations of atorvastatin. The dose of atorvastatin should not exceed a daily dose of 20 mg when co-administered with elbasvir/grazoprevir. Coadministration of atorvastatin (20 mg single dose) and grazoprevir (200 mg once daily) to 9 subjects increased grazoprevir AUC, Cmax and C24 by 26%, 26% and 11%, respectively. Coadministration of atorvastatin (10 mg single dose) and elbasvir + grazoprevir (50 + 200 mg once daily) to 16 subjects increased atorvastatin AUC and Cmax by 1.94-fold and 4.34-fold, but decreased Ctrough by 79%.

Coadministration of elbasvir/grazoprevir (50/200 mg, once daily) with atorvastatin (10 mg, single dose) was studied in 16 healthy volunteers in a two-period, fixed-sequence trial. Atorvastatin AIC and Cmax increased by 94% and 343%, respectively. Orthohydroxyatorvastatin AUC and Cmax increased by 91% and 634%, respectively. Dose adjustment of elbasvir/grazoprevir is not required. A dose reduction in atorvastatin is recommended, due to an increased risk of myopathy.