Table 2.
Statin drug–drug interactions
| Drug | Statins affected (risk rating) | Interaction | Mechanism |
|---|---|---|---|
| Cyclosporine | Atorvastatin (X), fluvastatin (D), lovastatin (X), pitavastatin (X), pravastatin (D), rosuvastatin (D), simvastatin (X) | Increased Cmax and AUC of statins (all) | Inhibition of OATP1B1 transport (all), CYP3A inhibition (atorvastatin, lovastatin, simvastatin) |
| Boceprevir | Atorvastatin (D), fluvastatin (C), lovastatin (X), pitavastatin (C), pravastatin (C), rosuvastatin (C), simvastatin (X) | Increased Cmax and AUC of statin (all) | Inhibition of OATP1B1 mediated transport (all), CYP3A inhibition (atorvastatin, lovastatin, simvastatin) |
| Telaprevir | Atorvastatin (X), fluvastatin (C), lovastatin (X), pitavastatin (C), pravastatin (C), rosuvastatin (C), simvastatin (X) | Increased Cmax and AUC of statin (all) | Inhibition of OATP1B1 mediated transport (all), CYP3A inhibition (atorvastatin, lovastatin, simvastatin) |
| Norfloxacin | Atorvastatin (C), lovastatin (C), simvastatin (C) | Possible increased Cmax and AUC of statin | Inhibition of CYP3A |
| Rifaximin | Atorvastatin (C) | Possible increase in Cmax and AUC of rifaximin | Atorvastatin inhibits p glycoprotein |
| Spironolactone | Atorvastatin (C) | Theoretical reduction of endogenous steroid activity | Additive effects on reducing endogenous steroid activity |
| Tenofovir | Atorvastatin (C), lovastatin (C), simvastatin (C) | Possible decrease in Cmax and AUC of statin | Induction of p glycoprotein |
Information in this table gathered from the Lexicomp online drug interaction database. Lexicomp risk rating: (A) no known interaction, (B) no action needed, (C) monitor therapy, (D) consider therapy modification, (X) avoid combination.
AUC, area under the curve.