Safety of Atorvastatin with Myrbetriq (Mirabegron)
Yes, atorvastatin can be safely taken with Myrbetriq (mirabegron) as there are no documented pharmacokinetic drug-drug interactions between these medications, and no dose adjustments are required. 1
No Direct Drug Interaction
- Mirabegron does not significantly inhibit or induce CYP3A4, the primary enzyme responsible for atorvastatin metabolism 1
- Mirabegron is not listed among the medications that increase risk of statin-associated myopathy in major cardiovascular guidelines 1
- Unlike drugs such as cyclosporine, gemfibrozil, macrolide antibiotics, or azole antifungals, mirabegron does not appear on the list of agents requiring statin dose adjustments 1
Standard Monitoring Applies
- Monitor for typical statin-related muscle symptoms (soreness, tenderness, or pain) at baseline, 6-8 weeks after starting therapy, and at each follow-up visit 1
- Check hepatic transaminases before and during treatment according to standard statin monitoring protocols 1
- Evaluate for headache and dyspepsia, which are common statin side effects 1
Important Cardiovascular Consideration
- Be aware that mirabegron itself may potentially worsen atherosclerosis in patients with existing cardiovascular disease through activation of brown fat-mediated lipolysis, which can increase LDL-cholesterol and VLDL-cholesterol remnants 2
- This atherosclerotic concern is separate from any drug interaction and relates to mirabegron's mechanism of action as a β3-adrenergic receptor agonist 2
- The decision to use mirabegron in patients already requiring statin therapy for cardiovascular disease should weigh the bladder symptom benefits against potential cardiovascular risks 2
No Dose Adjustment Required
- Atorvastatin can be prescribed at standard doses (10-80 mg daily) based on LDL-C targets when used with mirabegron 1
- Unlike combinations with sacubitril/valsartan or certain other cardiovascular medications, no maximum dose restrictions apply specifically for the atorvastatin-mirabegron combination 1
Common Pitfall to Avoid
- Do not confuse the safe combination of atorvastatin and mirabegron with problematic statin interactions involving CYP3A4 inhibitors (such as clarithromycin, itraconazole, or ritonavir), which significantly increase atorvastatin levels and myopathy risk 1