FDA updates guidance for use of HIV and hepatitis C protease inhibitors with statins

Medicine regulatory authorities in the US have updated their recommendations concerning possible interactions between statins and protease inhibitors used to treat HIV and hepatitis C.

Guidance from the Food and Drug Administration (FDA) emphasises that lovastatin (Mevacor) and simvastatin (Zocor) should never be taken with either HIV or hepatitis C protease inhibitors.

Statins are a class of drug used to reduce levels of cholesterol in the blood. They are widely used by patients taking protease inhibitors, which can cause metabolic disturbances, including an increase in both cholesterol and triglycerides.

Several statins and protease inhibitors are metabolised by the body using the same pathway. This can mean that blood levels of statins may be increased, potentially leading to muscle damage, or myopathy. The most severe form of myopathy is called rhabdomyolysis. This can damage the kidneys, leading to kidney failure, which can be fatal.

Specific information on potential interactions and how to manage them is provided in the table below.

The FDA recommendations also emphasise the importance of HIV-positive patients informing their doctors of all medications they are taking.