No pharmaceutical opinion available for this interaction.
Darunavir / ritonavir may inhibit the transporters (OATP1B1 and OATP1B3) and increase the plasma concentration Pravastatin.
2C9, 2C19, 2C8 (moderate), UGT (moderate)
3A4 (strong), 2D6 (moderate), 2B6 (probable)
OATP1B1 and OATP1B3
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.
Symptoms of toxicity associated with hypolipidemic agents : gastrointestinal effects, fatigue and muscular weaknesses, myalgias, muscular cramps, myopathies, rhabdomyolysis and myoglobinuria leading to renal insufficiency.
|40 mg||40 mg|
|+ 81%||+ 21%|
|600/100 mg||600/100 mg|
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.