https://interactions.guidetherapeutiquevih.com/en/interaction-details?id=13515
https://interactions.guidetherapeutiquevih.com/en/interaction-details?id=13515
No pharmaceutical opinion available for this interaction.
Cobicistat can inhibit the metabolism (CYP 3A4) and increase the plasma concentration of Lovastatin.
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Possible increased risk of HMG CoA inhibitor toxicity.
Contraindicated. Use alternative.
See atorvastatin, rosuvastatin and pravastatin.
Symptoms of toxicity associated with hypolipidemic agents : gastrointestinal effects, fatigue and muscular weaknesses, myalgias, muscular cramps, myopathies, rhabdomyolysis and myoglobinuria leading to renal insufficiency.
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Due to the significant first-pass effect of lovastatin and simvastatin in the liver via CYP3A4, coadministration of these drugs with PIs is contraindicated. Cases of rhabdomyolysis have been reported.
A pharmacokinetic study with simvastatin 40 mg QD and saquinavir/ritonavir 400/400 mg BID demonstrated a 30-fold increase in simvastatin AUC.
See saquinavir/ritonavir + simvastatin.