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. Author manuscript; available in PMC: 2022 Oct 4.
Published in final edited form as: Can J Cardiol. 2018 Dec 4;35(3):270–279. doi: 10.1016/j.cjca.2018.11.029

Table 3.

Drug Interactions between antiretroviral therapy and cardiovascular drugs

Statins Antiplatelets Anticoagulants
Protease inhibitors - inhibit CYP3A4 Suggested use:

  1. Pitavastatin and Pravastatin

  2. Atorvastatin and Rosuvastatin (careful monitoring)


Contraindicated:
 Lovastatin and Simvastatin		 Clopidogrel:
 Drug of choice
Prasugrel:
 Decreased activation
Ticagrelor:
 Decreased metabolism		 Dabigatran:
 Drug of choice (separate administration with Ritonavir by 2 h)
Apixaban and Rivaroxaban:
 Decreased metabolism
Non-nucleoside reverse transcriptase inhibitors - induced CYP3A4 Increase metabolism. Careful monitoring is recommended because clinical efficacy might be decreased. No clinical effect aside from Efavirenz and Etravirine, which inhibit CYP2C19, leading to decreased activation of clopidogrel. Dabigatran:
 Drug of choice
Apixaban and Rivaroxaban:
 Increased metabolism