30
Treatment
Table 6. Effect of Protease Inhibitors and Nonnucleoside
Reverse Transcriptase Inhibitors (NNRTIs) on
Statins
Statin Protease Inhibitors NNRTI
Atorvastatin Caution (moderately increase
atorvastatin's AUC). Use lowest
starting atorvastatin dose.
Acceptable with
appropriate dosing and
monitoring. Efavirenz
and etravirine decrease
atorvastatin's AUC. No
data for nevirapine. May
need higher atorvastatin
starting dose. Doravirine
does not affect levels of
atorvastatin.
Fluvastatin NOT
recommended with nelfinavir.
Use of other protease inhibitors is
allowed with appropriate dosing
and monitoring.
Acceptable with appropriate
dosing and monitoring.
Etravirine may increase
fluvastatin's AUC. May need
lower fluvastatin starting
dose with etravirine. No
data on doravirine.
Lovastatin Contraindicated (greatly increase
lovastatin's AUC)
Acceptable with
appropriate dosing and
monitoring. Decreases
simvastatin's AUC, so may
need higher lovastatin
starting dose. No data on
doravirine.
Pitavastatin Acceptable with appropriate dosing
and monitoring. No significant
change in pitavastatin's AUC with
lopinavir/ritonavir. Pitavastatin's
mean AUC decreased 26% with
darunavir.
No data for NNRTIs.
Pravastatin Acceptable with appropriate dosing
and monitoring, except with
darunavir. Decrease in pravastatin's
AUC, except with darunavir, which
increases pravastatin's AUC by 81%.
Acceptable with
appropriate dosing and
monitoring. Efavirenz
decreases pravastatin's
AUC, but no change with
etravirine. No data for
nevirapine, rilpivirine,
doravirine. May need
higher pravastatin starting
dose with efavirenz.
