75
Table 22. Antiretroviral Therapy and Statin Drug Interactions
Statin Antiretroviral Drug Recommendations
Protease Inhibitors
Atorvastatin Atazanavir
Atazanavir/ritonavir
Titrate atorvastatin dose carefully and
administer the lowest effective dose while
monitoring for toxicities.
Atazanavir/cobicistat Do not coadminister.
Darunavir/cobicistat
Darunavir/ritonavir
Titrate atorvastatin dose carefully and administer
the lowest effective dose while monitoring for
toxicities. Do not exceed atorvastatin 20 mg daily.
Lopinavir/ritonavir Titrate atorvastatin dose carefully and administer
the lowest effective dose while monitoring for
toxicities. Do not exceed atorvastatin 20 mg daily.
Tipranavir/ritonavir Do not co-administer.
Lovastatin All protease
inhibitors
Contraindicated.
Pitavastatin All protease
inhibitors
No dose adjustment needed.
Pravastatin Atazanavir/ritonavir
Atazanavir/cobicistat
Titrate pravastatin dose carefully while monitoring
for pravastatin-related adverse events.
Darunavir/cobicistat
Darunavir/ritonavir
Titrate pravastatin dose carefully while monitoring
for pravastatin-related adverse events.
Lopinavir/ritonavir No dose adjustment needed.
Rosuvastatin Atazanavir/ritonavir Titrate rosuvastatin dose carefully and administer
lowest effective dose while monitoring for
rosuvastatin-related adverse events.
Atazanavir/cobicistat Do not exceed rosuvastatin 10 mg daily.
Darunavir/cobicistat Titrate rosuvastatin dose carefully and administer
lowest effective dose while monitoring for
rosuvastatin-related adverse events. Do not
exceed rosuvastatin 20 mg daily.
Darunavir/ritonavir Titrate rosuvastatin dose carefully and administer
the lowest effective dose while monitoring for
rosuvastatin-related adverse events.
Lopinavir/ritonavir Titrate rosuvastatin dose carefully and administer
the lowest effective dose. Do not exceed
rosuvastatin 10 mg daily.
Tipranavir/ritonavir No dose adjustment needed.
Simvastatin All protease inhibitors Contraindicated.
