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Drug interactions with anti-retrovirals are frequent and can be dangerous. Protease inhibitors (PIs) inhibit the metabolism of simvastatin, and co-administration is contraindicated. Despite this, we have seen a recent cluster of patients prescribed simvastatin whilst on PIs.
A 58-year-old man was taking abacavir, lamivudine, atazanavir and ritonavir. His HIV physician noted raised cholesterol and wrote to the patient and his general practitioner (GP), stating that simvastatin is not recommended with his antiretroviral combination, but low dose atorvastatin or pravastatin …
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