▶St John’s Wortis predicted to decrease the exposure to
velpatasvir. Avoid.oTheoretical
▶St John’s Wortis predicted to decrease the exposure to
venetoclax. Avoid.rStudy
▶St John’s Wortis predicted to decrease the exposure to
vismodegib. Avoid.oTheoretical
▶St John’s Wortis predicted to decrease the concentration of
voxilaprevir. Avoid.rTheoretical
Statins→seeTABLE 1p. 847 (hepatotoxicity)
atorvastatin.fluvastatin.pravastatin.rosuvastatin.simvastatin..
▶Atorvastatinslightly to moderately increases the exposure to
aliskiren.oStudy
▶Antacidsmoderately decrease the absorption ofrosuvastatin.
Separate administration by 2 hours.oStudy
▶Antiarrhythmics(amiodarone)are predicted to increase the risk
of rhabdomyolysis when given withatorvastatin. Monitor and
adjust dose.oTheoretical
▶Antiarrhythmics(amiodarone)are predicted to increase the
exposure tofluvastatin.rTheoretical
▶Antiarrhythmics(amiodarone)increase the risk of
rhabdomyolysis when given withsimvastatin. Adjust
simvastatindose,p. 134.rStudy
▶Antiarrhythmics(dronedarone)are predicted to increase the
exposure toatorvastatin. Monitor and adjust dose.r
Study
▶Antiarrhythmics(dronedarone)slightly increase the exposure to
rosuvastatin. Adjust dose.rStudy
▶Antiarrhythmics(dronedarone)are predicted to increase the
exposure tosimvastatin. Use with caution and adjust
simvastatindose,p. 134.rStudy
▶Antiepileptics(carbamazepine)moderately decrease the
exposure tosimvastatin. Monitor and adjust dose.r
Study→Also seeTABLE 1p. 847
▶Antiepileptics(carbamazepine, eslicarbazepine)are predicted to
decrease the exposure toatorvastatin. Monitor and adjust
dose.oTheoretical→Also seeTABLE 1p. 847
▶Antiepileptics(eslicarbazepine)moderately decrease the
exposure tosimvastatin. Monitor and adjust dose.o
Study
▶Antiepileptics(fosphenytoin, phenytoin)potentially decrease
the exposure tostatins(atorvastatin, simvastatin).o
Anecdotal
▶Antifungals, azoles(fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure toatorvastatin.
Monitor and adjust dose.rStudy→Also seeTABLE 1p. 847
▶Antifungals, azoles(fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure tosimvastatin. Use with
caution and adjustsimvastatindose,p. 134.rStudy→Also
seeTABLE 1p. 847
▶Antifungals, azoles(fluconazole, miconazole)are predicted to
increase the exposure tofluvastatin.rTheoretical→Also
seeTABLE 1p. 847
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the exposure toatorvastatin. Avoid or
adjust dose and monitor rhabdomyolysis.rStudy→Also
seeTABLE 1p. 847
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the exposure tosimvastatin. Avoid.
rStudy→Also seeTABLE 1p. 847
▶Antifungals, azoles(miconazole)potentially increase the
exposure toatorvastatin.rAnecdotal
▶Antifungals, azoles(miconazole)are predicted to increase the
exposure tosimvastatin. Avoid.rTheoretical
▶Aprepitantis predicted to increase the exposure to
atorvastatin. Monitor and adjust dose.rStudy
▶Aprepitantis predicted to increase the exposure to
simvastatin. Use with caution and adjustsimvastatindose,
p. 134.rStudy
▶Bosentanslightly decreases the exposure toatorvastatin.n
Study
▶Bosentanmoderately decreases the exposure tosimvastatin.
oStudy
▶Calcium channel blockers(amlodipine)slightly increase the
exposure tosimvastatin. Adjustsimvastatindose,p. 134.n
Study
▶Calcium channel blockers(diltiazem, verapamil)are predicted to
increase the exposure toatorvastatin. Monitor and adjust
dose.rStudy
▶Calcium channel blockers(diltiazem, verapamil)are predicted to
increase the exposure tosimvastatin. Use with caution and
adjustsimvastatindose,p. 134.rStudy
▶Cephalosporins(ceftobiprole)are predicted to increase the
concentration ofstatins.oTheoretical
▶Ciclosporinvery markedly increases the exposure to
atorvastatin. Avoid or adjustatorvastatindose,p. 132.r
Study
▶Ciclosporinmoderately increases the exposure tofluvastatin.
rStudy
▶Ciclosporinmarkedly to very markedly increases the exposure
topravastatin. Adjust dose.rStudy
▶Ciclosporinmarkedly increases the exposure tostatins
(rosuvastatin, simvastatin). Avoid.rStudy
▶Clopidogrelincreases the exposure torosuvastatin. Adjust
rosuvastatindose,p. 133.oStudy
▶Cobicistatis predicted to increase the exposure toatorvastatin.
Avoid or adjust dose and monitor rhabdomyolysis.r
Study
▶Cobicistatis predicted to increase the exposure tosimvastatin.
Avoid.rStudy
▶Colchicineincreases the risk of rhabdomyolysis when given
withstatins.rAnecdotal
▶Statins(fluvastatin, rosuvastatin)increase the anticoagulant
effect ofcoumarins. Monitor INR and adjust dose.rStudy
▶Crizotinibis predicted to increase the exposure toatorvastatin.
Monitor and adjust dose.rStudy
▶Crizotinibis predicted to increase the exposure tosimvastatin.
Use with caution and adjustsimvastatindose,p. 134.r
Study
▶Danazolis predicted to increase the risk of rhabdomyolysis
when given withatorvastatin.rTheoretical
▶Danazolincreases the risk of rhabdomyolysis when given with
simvastatin. Avoid.rAnecdotal
▶Statinsare predicted to increase the risk of rhabdomyolysis
when given withdaptomycin.rTheoretical
▶Dasabuvirincreases the exposure torosuvastatin. Adjust
rosuvastatindose,p. 133.oStudy
▶Dasatinibis predicted to increase the exposure tosimvastatin.
oTheoretical
▶Efavirenzslightly decreases the exposure toatorvastatin.n
Study
▶Efavirenzmoderately decreases the exposure tosimvastatin.
oStudy
▶Elbasvirpotentially increases the exposure toatorvastatin.
Adjustatorvastatindose,p. 132.oStudy
▶Elbasviris predicted to increase the exposure tofluvastatin.
Adjustfluvastatindose,p. 132.qTheoretical
▶Elbasvirincreases the exposure torosuvastatin. Adjust
rosuvastatindose,p. 133.oStudy
▶Elbasviris predicted to increase the exposure tosimvastatin.
Adjustsimvastatindose,p. 134.qTheoretical
▶Eltrombopagis predicted to increase the exposure tostatins.
Monitor and adjust dose.oStudy
▶Eluxadolineis predicted to increase the exposure tostatins.
oStudy
▶Enzalutamideis predicted to decrease the exposure to
simvastatin.rStudy
▶Ezetimibepotentially increases the risk of rhabdomyolysis
when given withstatins.rAnecdotal
▶Fibrates(bezafibrate, ciprofibrate)increase the risk of
rhabdomyolysis when given withpravastatin. Avoid.r
Study
▶Fibrates(bezafibrate, ciprofibrate)increase the risk of
rhabdomyolysis when given withrosuvastatin. Adjust
rosuvastatindose,p. 133.rStudy
▶Fibrates(bezafibrate, ciprofibrate)increase the risk of
rhabdomyolysis when given withsimvastatin. Adjust
simvastatindose,p. 134.rStudy
▶Fibrates(ciprofibrate)increase the risk of rhabdomyolysis
when given withatorvastatin. Avoid or adjust dose.r
StudyBNFC 2018 – 2019 St John’s Wort—Statins 993
Interactions|Appendix 1A1