March 2nd, 2012

Statins and Protease Inhibitors May Interact, Causing Rhabdomyolysis

The FDA is warning again about interactions between protease inhibitors and certain statins that can lead to rhabdomyolysis. Protease inhibitors are used to treat HIV and hepatitis C.

In a safety communication, the agency published a list of statins that should either be avoided or whose dosing levels should be limited when coadministered with protease inhibitors. Atorvastatin, lovastatin, rosuvastatin, and simvastatin are either listed as contraindicated or have had limits put on dosages.

In particular, lovastatin and simvastatin exposures can increase beyond 10-fold when used with protease inhibitors, and rosuvastatin exposure can increase up to 3-fold, according to the FDA.

Earlier this week, the agency announced several changes to statin labels, including a warning to avoid lovastatin in combination with HIV protease inhibitors.

This post is reprinted from Physician’s First Watch, a part of the Journal Watch family. PFW is a free daily alert on current news that affects your practice — from medical journals, government agencies, scientific conferences, and major media reports.

One Response to “Statins and Protease Inhibitors May Interact, Causing Rhabdomyolysis”

  1. David Kaufman, MD says:

    OMG it never stops. I have been treating HIV patients since 1980. In 1995 the sun broke thru the clouds and nothing has been the same since. For at least the last 12 years I, along with hundreds of HIV specialists, have been treating our patients with protease inhibitors (PIs) and statins because of their lipid abnormalties and increased risk of heart disease. I have used atorvastatin, rosuvastatin, etc in literally hundreds of patients on PIs and never had a case of rhabdo. Warnings like this simply scare patients and their physicians. I wonder: was a single HIV specialist who actually treats patients on whatever committee that made this decision and issued this “safety communication”. And, I would add, this is very very “old news”,not a new issue to any HIV doc.