https://interactions.guidetherapeutiquevih.com/en/interaction-details?id=7951
No pharmaceutical opinion available for this interaction.
Darunavir / ritonavir may inhibit the transporters (OATP1B1 and OATP1B3) and increase the plasma concentration Pravastatin.
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Possible increased risk of HMG CoA inhibitor toxicity.
Use this combination with caution.
Start with a small dosage. Monitor closely for signs and symptoms of toxicity and adjust dosage as a function of efficacy and tolerance.
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Symptoms of toxicity associated with hypolipidemic agents : gastrointestinal effects, fatigue and muscular weaknesses, myalgias, muscular cramps, myopathies, rhabdomyolysis and myoglobinuria leading to renal insufficiency.
AST
ALT
CK
Lipidic profile
Reference number |
---|
# patients |
Dose |
Frequency |
AUC |
Cmax |
HIV |
Duration (days) |
2129 | 2380 |
---|---|
14 | 28 |
40 mg | 40 mg |
QD | QD |
+ 81% | + 21% |
+ 63% | |
+ | - |
1-4; 15-18* |
2129 | 2380 |
---|---|
14 | 28 |
600/100 mg | 600/100 mg |
BID | BID |
+ | - |
7 | 12-14; 15-18* |
Ref #2129: Wide variations in pravastatin concentrations between patients.
**The coadministration is generally well tolerated but due to wide variabilities between individuals, it is still recommended to start with a low dose of Pravastatin
** 4 patients on 14 have had an increase of AUC of 200% for Pravastatin.
Ref #2380: * Subjects received pravastatin (40 mg daily) on days 1-4, darunavir/ritonavir (600/100 mg twice daily) on days 12-14 and all drugs on days 15-18. Across all subjects, DRV/R increased pravastatin AUC by 21% (90% Cl=1.04-1.41). The effect of DRV/R on pravastatin AUC was less in this study than previously reported.
Réf #3391 : Case report of rhabdomyolysis in a patient on elvitegravir/cobicistat and pravastatin/fenofibrate.