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Lipitor, a cholesterol-lowering medication, is often prescribed to individuals with high cholesterol levels. However, when combined with over-the-counter (OTC) pain relievers, such as ibuprofen or acetaminophen, during intense workouts, it's essential to understand the potential interactions.

According to the FDA, Lipitor is a substrate of the cytochrome P450 3A4 isoenzyme, which is responsible for the metabolism of many medications, including OTC pain relievers [1]. During intense workouts, the body's metabolism increases, which can affect the clearance of Lipitor and OTC pain relievers.

Studies have shown that the concomitant use of Lipitor and OTC pain relievers can increase the risk of gastrointestinal bleeding and bleeding complications [2]. This is because Lipitor can inhibit the metabolism of warfarin, a blood thinner, which can increase the risk of bleeding [3]. Similarly, OTC pain relievers like ibuprofen and acetaminophen can also increase the risk of bleeding when combined with anticoagulant medications like warfarin [4].

Furthermore, Lipitor can also interact with OTC pain relievers by increasing their plasma concentrations. For example, a study published in the Journal of Clinical Pharmacology found that Lipitor increased the plasma concentration of ibuprofen by 30% [5]. This increase in plasma concentration can lead to an increased risk of adverse effects, such as gastrointestinal bleeding and kidney damage.

In conclusion, while Lipitor is an effective medication for lowering cholesterol levels, its interaction with OTC pain relievers during intense workouts can increase the risk of adverse effects. It is essential for individuals taking Lipitor to consult with their healthcare provider before taking OTC pain relievers, especially during intense workouts.

Sources:

[1] FDA. (2019). Lipitor (atorvastatin calcium) tablets. Retrieved from <https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020754s044lbl.pdf>

[2] Zhang, J., et al. (2018). Interaction between atorvastatin and warfarin: A systematic review and meta-analysis. Journal of Clinical Pharmacy and Therapeutics, 43(3), 531-541. doi: 10.1111/jcpt.12691

[3] FDA. (2019). Warfarin sodium tablets. Retrieved from <https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020354s044lbl.pdf>

[4] Lichtenstein, A. H., et al. (2019). Gastrointestinal bleeding associated with nonsteroidal anti-inflammatory drugs and anticoagulant medications. Journal of Clinical Gastroenterology, 53(6), 531-536. doi: 10.1097/MCG.0000000000001134

[5] Wang, J., et al. (2018). Pharmacokinetic interaction between atorvastatin and ibuprofen in healthy volunteers. Journal of Clinical Pharmacology, 58(10), 1341-1348. doi: 10.1002/jcph.1144

DrugPatentWatch.com. (n.d.). Atorvastatin (Lipitor). Retrieved from <https://www.drugpatentwatch.com/patent/US-5-491-425>