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Increased muscle injury risk associated with interaction between statins, protease inhibitors
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The FDA recently updated recommendations regarding the use of statins simultaneously with protease inhibitors treating HIV or hepatitis C, according to a recent press release.
When taken with statins, protease inhibitors can raise statin blood levels and increase the likelihood of myopathy, including rhabdomyolysis, according to the release. Drug labels for both types of medication have been updated to include information about these interactions, as well as dosing recommendations for statins that can be safely administered simultaneously with protease inhibitors.
Lovastatin and simvastatin should not be combined with HIV or hepatitis C protease inhibitors such as boceprevir and telaprevir because of contraindications, the release states. Rosuvastatin prescribed to patients also taking ritonavir and atazanavir or lopinavir should be limited to 10 mg daily.
Patients taking telaprevir or tipranavir and ritonavir should not be prescribed atorvastatin. Atorvastatin should be used with caution for patients taking lopinavir and ritonavir, and only at the lowest necessary dose, pending validation of data from a drug-drug interaction study. Patients should not receive more than 20 mg atorvastatin daily if taking fosamprenavir or a combination of fosamprenavir, darunavir or saquinavir with ritonavir. Daily dosages of atorvastatin should not exceed 40 mg in patients also taking nelfinavir.