Statins(continued)
▶Fibrates(ciprofibrate)increase the risk of rhabdomyolysis
when given withfluvastatin.rStudy
▶Fibrates(fenofibrate)are predicted to increase the risk of
rhabdomyolysis when given withfluvastatin. Adjust
fenofibratedose,p. 131.rTheoretical
▶Fibrates(fenofibrate)are predicted to increase the risk of
rhabdomyolysis when given withpravastatin. Avoid.r
Theoretical
▶Fibrates(fenofibrate)increase the risk of rhabdomyolysis when
given withrosuvastatin. Adjustfenofibrateandrosuvastatin
doses,p. 131, p. 133.rAnecdotal
▶Fibrates(gemfibrozil)increase the risk of rhabdomyolysis when
given withstatins. Avoid.rAnecdotal
▶Fibrates(bezafibrate)increase the risk of rhabdomyolysis when
given withstatins(atorvastatin, fluvastatin).rStudy
▶Fibrates(fenofibrate)increase the risk of rhabdomyolysis when
given withstatins(atorvastatin, simvastatin). Adjust
fenofibratedose,p. 131.rAnecdotal
▶Fusidic acidincreases the risk of rhabdomyolysis when given
withstatins. Avoid.rAnecdotal
▶Glecaprevir(with pibrentasvir) is predicted to increase the
exposure tofluvastatin.oTheoretical
▶Glecaprevir(with pibrentasvir) increases the exposure to
pravastatin. Use with caution and adjustpravastatindose,
p. 133.oStudy
▶Glecaprevir(with pibrentasvir) increases the exposure to
rosuvastatin. Use with caution and adjustrosuvastatindose,
p. 133.oStudy
▶Glecaprevir(with pibrentasvir) increases the exposure to
statins(atorvastatin, simvastatin). Avoid.oStudy
▶Grapefruit juiceincreases the exposure toatorvastatin.n
Study
▶Grapefruit juiceincreases the exposure tosimvastatin. Avoid.
rStudy
▶Grazoprevirincreases the exposure toatorvastatin. Adjust
atorvastatindose,p. 132.oStudy
▶Grazopreviris predicted to increase the exposure to
fluvastatin. Adjustfluvastatindose,p. 132.qTheoretical
▶Grazoprevirincreases the exposure torosuvastatin. Adjust
rosuvastatindose,p. 133.oStudy
▶Grazopreviris predicted to increase the exposure to
simvastatin. Adjustsimvastatindose,p. 134.qTheoretical
▶HIV-protease inhibitorsare predicted to increase the exposure
toatorvastatin. Avoid or adjust dose and monitor
rhabdomyolysis.rStudy
▶HIV-protease inhibitorsslightly to moderately increase the
exposure torosuvastatin. Avoid or adjust dose.rStudy
▶HIV-protease inhibitorsare predicted to increase the exposure
tosimvastatin. Avoid.rStudy
▶Idelalisibis predicted to increase the exposure toatorvastatin.
Avoid or adjust dose and monitor rhabdomyolysis.r
Study
▶Idelalisibis predicted to increase the exposure tosimvastatin.
Avoid.rStudy
▶Imatinibis predicted to increase the exposure toatorvastatin.
Monitor and adjust dose.rStudy
▶Imatinibis predicted to increase the exposure tosimvastatin.
Use with caution and adjustsimvastatindose,p. 134.r
Study
▶Ledipasviris predicted to increase the exposure to
rosuvastatin. Avoid.rTheoretical
▶Ledipasviris predicted to increase the exposure tostatins
(atorvastatin, fluvastatin, pravastatin, simvastatin). Monitor
and adjust dose.oTheoretical
▶Leflunomideis predicted to increase the exposure to
rosuvastatin. Adjust dose.oStudy→Also seeTABLE 1
p. 847
▶Lomitapideincreases the exposure toatorvastatin. Adjust
lomitapidedose or separate administration by 12 hours.n
Study→Also seeTABLE 1p. 847
▶Lomitapideincreases the exposure tosimvastatin. Monitor and
adjustsimvastatindose,p. 134.oStudy→Also seeTABLE 1
p. 847▶Macrolides(clarithromycin)are predicted to increase the
exposure toatorvastatin. Avoid or adjust dose and monitor
rhabdomyolysis.rStudy
▶Macrolides(clarithromycin)moderately increase the exposure
topravastatin.rStudy
▶Macrolides(clarithromycin)are predicted to increase the
exposure tosimvastatin. Avoid.rStudy
▶Macrolides(erythromycin)are predicted to increase the
exposure toatorvastatin. Monitor and adjust dose.r
Study
▶Macrolides(erythromycin)are predicted to increase the
exposure topravastatin.rStudy
▶Macrolides(erythromycin)are predicted to increase the
exposure tosimvastatin. Use with caution and adjust
simvastatindose,p. 134.rStudy
▶Mitotaneis predicted to decrease the exposure tosimvastatin.
rStudy
▶Monoclonal antibodies(sarilumab)are predicted to decrease the
exposure tostatins(atorvastatin, simvastatin).oStudy
▶Monoclonal antibodies(tocilizumab)are predicted to decrease
the exposure tostatins(atorvastatin, simvastatin). Monitor and
adjust dose.oStudy
▶Netupitantis predicted to increase the exposure to
atorvastatin. Monitor and adjust dose.rStudy
▶Netupitantis predicted to increase the exposure to
simvastatin. Use with caution and adjustsimvastatindose,
p. 134.rStudy
▶Nevirapineslightly decreases the exposure toatorvastatin.
nStudy
▶Nevirapinemoderately decreases the exposure tosimvastatin.
oStudy
▶Nicotinic acidis predicted to increase the risk of
rhabdomyolysis when given withstatins.rTheoretical
▶Nilotinibis predicted to increase the exposure toatorvastatin.
Monitor and adjust dose.rStudy
▶Nilotinibis predicted to increase the exposure tosimvastatin.
Use with caution and adjustsimvastatindose,p. 134.r
Study
▶Osimertinibslightly increases the exposure torosuvastatin.
oStudy
▶Paritaprevir(with ritonavir and ombitasvir) is predicted to
increase the exposure tofluvastatin. Avoid.o
Theoretical
▶Paritaprevir(with ritonavir and ombitasvir) increases the
exposure topravastatin. Adjustpravastatindose,p. 133.
oStudy
▶Paritaprevir(with ritonavir and ombitasvir) increases the
exposure torosuvastatin. Adjustrosuvastatindose,p. 133.
oStudy
▶Rosuvastatinis predicted to increase the anticoagulant effect
ofphenindione. Monitor INR and adjust dose.rTheoretical
▶Pibrentasvir(with glecaprevir) is predicted to increase the
exposure tofluvastatin.oTheoretical
▶Pibrentasvir(with glecaprevir) increases the exposure to
pravastatin. Use with caution and adjustpravastatindose,
p. 133.oStudy
▶Pibrentasvir(with glecaprevir) increases the exposure to
rosuvastatin. Use with caution and adjustrosuvastatindose,
p. 133.oStudy
▶Pibrentasvir(with glecaprevir) increases the exposure to
statins(atorvastatin, simvastatin). Avoid.oStudy
▶Ranolazineis predicted to increase the exposure to
atorvastatin.oTheoretical
▶Ranolazineslightly increases the exposure tosimvastatin.
Adjustsimvastatindose,p. 134.oStudy
▶Regorafenibis predicted to increase the exposure tostatins
(atorvastatin, fluvastatin, rosuvastatin).rTheoretical
▶Ribociclib(high-dose) is predicted to increase the exposure to
simvastatin. Avoid.oTheoretical
▶Rifampicinmarkedly decreases the exposure toatorvastatin.
Atorvastatinshould be taken at the same time asrifampicin,
p. 132, p. 364.oStudy
▶Rifampicinmoderately decreases the exposure tofluvastatin.
Monitor and adjust dose.oStudy994 Statins—Statins BNFC 2018 – 2019
Interactions|Appendix 1A1