Omeprazole-atorvastatin interaction. Possible benefit?

[V_Drake]

It is easy to find information regarding drug-drug interactions for omeprazole (Prilosec) and atorvastatin (Lipitor). The omeprazole appears to increase the bioavailability of the statin, increasing the risk of side effects. Does this mean that the interaction is like taking a higher dose of the statin, which would provide benefit for someone like me who only takes a low dose (10mg atorvastatin daily) and has no statin tolerance issues?

[specialmom]

Statins do not seem to have a tolerance issue. Are you having trouble controlling your cholesterol on your 10 mg dose?  

Atorvastatin is supposed to be one of the two most effective statins in lowing cholesterol so you are on a good one. Bioavailability is how well a med is absorbed and used by the body and bioavailability varies among the statins. It's actually a desired thing. The liver is the target organ so if it is slowed down in the liver (where this happens), it's in the target organ. But honestly, that is hard for me to understand.

However, to answer your question, there IS evidence that there is a boost in effect with the PPI, prilosec and atorvastatin in terms of reduction of cholesterol. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5033144/  You can copy and paste that article. It's supposed to be fairly modest. This article also talks about increased effect and blood levels of atorvastatin with this combination. https://www.drugs.com/drug-interactions/lipitor-with-prilosec-276-128-1750-1118.html

I would talk to your doctor before doing this though to be on the same page.

[V_Drake]

Thanks. That’s a modest effect size in a small sample, but it helps confirm that the interaction boosts bioavailability of  the drug. PPIs are so effective they have tons of known interactions with different mechanisms of action (e.g., extended release drugs can get messed up; increased bioavailability can raise levels of high toxicity meds (like colchicine) to a concerning degree). To answer your question, my lipids are very well controlled at 10mg dose. I don’t want to take omeprazole, as I sometimes do, if the interaction lowered bioavailability. I am unconcerned about a modest increase in effective dose, but I imagine high-dose statin users with CKD, etc. should take the interaction seriously. Again, thanks!