61
Magnitude Recommendation
Severe
6- to 15-fold increase in AUC of atorvastatin
Limit dose of atorvastatin to 10 mg daily
Severe
7-fold increase in AUC of rosuvastatin
Limit dose of rosuvastatin to 5 mg daily
Severe
5- to 10-fold increase in AUC of pravastatin
Limit dose of pravastatin to 40 mg daily
Moderate
2- to 4-fold increase in AUC of fluvastatin
Limit dose of fluvastatin to 40 mg daily
Severe
6- to 8-fold increase in AUC of simvastatin
Avoid combination
Severe
5- to 20-fold increase in AUC of lovastatin
Avoid combination
Severe
5-fold increase in AUC of pitavastatin
Avoid combination
Magnitude of drug-drug interactions based on AUC increase: minor, >1.25 to <2; moderate,
≥2 to 4.9; and severe, ≥5.
* Changes in magnitude of statin AUC are reported with cyclosporine. Limited data exist
with tacrolimus, everolimus, and sirolimus.
AUC indicates area under the curve
Adapted with permission from Wiggins BS, et al. Circulation. 2016;134:e468-e495.
Copyright 2016 American Heart Association, Inc.
8.1. Cost and Value Considerations
COR LOE
Recommendation
1 B-NR 1. When discussing treatment and prevention with patients
who have CCD, it is recommended that the health care team
discuss out-of-pocket costs for medications at the time of
initiating a new medication and at least annually thereafter to
preempt cost-related nonadherence.
Other Important Considerations
