Liverpool HIV Interactions

No Interaction Expected

Rilpivirine/ Emtricitabine/Tenofovir-DF (RPV/FTC/TDF)

Atorvastatin

Quality of Evidence: Very Low

Summary:

Coadministration with Eviplera/Complera has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Coadministration of rilpivirine (150 mg once daily) and atorvastatin (40 mg once daily) decreased rilpivirine Cmax, AUC and Cmin by 9%, 10% and 10%, respectively. Atorvastatin Cmax and AUC increased by 35% and 4%; Cmin decreased by 15%. Cmax, AUC and Cmin of 2-hydroxy atorvastatin increased by 58%, 39% and 32%, whilst Cmax and AUC of 4-hydroxy atorvastatin increased by 28% and 23%. No dose adjustment is needed for either drug. [Note: this interaction study has been performed with a dose higher than the licensed dose for rilpivirine assessing the maximal effect on the co-administered drug. The dosing recommendation is applicable to the licensed dose of rilpivirine 25 mg once daily.] Emtricitabine and tenofovir-DF do not interact with atorvastatin metabolic pathway.

Description:

The interaction between atorvastatin and emtricitabine or tenofovir disoproxil had not been studied. Coadministration of atorvastatin (40 mg once daily) and rilpivirine had no effect on atorvastatin AUC, decreased Cmin by 15% and increased Cmax by 35%; there was no change in rilpivirine AUC or Cmin, but Cmax decreased by 9%. No dose adjustment is required. (This interaction study has been performed with a dose higher than the recommended dose for rilpivirine hydrochloride assessing the maximal effect on the co-administered medicinal product. The dosing recommendation is applicable to the recommended dose of rilpivirine of 25 mg once daily.)

Eviplera Summary of Product Information, Gilead Sciences Ltd, August 2021.

No clinically significant drug interactions have been observed between RPV and atorvastatin. Coadministration of atorvastatin (40 mg once daily) and rilpivirine (150 mg once daily) was studied in 16 subjects. Rilpivirine Cmax, AUC and Cmin decreased by 9%, 10% and 10%, respectively. Atorvastatin Cmax and AUC increased by 35% and 4% but Cmin decreased by 15%. Cmax, AUC and Cmin of 2-hydroxy-atorvastatin increased by 58%, 39% and 32%, respectively; Cmax and AUC of 4-hydroxy-atorvastatin increased by 28% and 23%. (The interaction study has been performed with a dose higher than the recommended dose for RPV (25 mg once daily) assessing the maximal effect on the coadministered drug.)

Complera US Prescribing Information, Gilead Sciences Inc, November 2019.

Coadministration of rilpivirine (150 mg once daily) and atorvastatin (40 mg once daily) was studied in 16 HIV-negative subjects. Rilpivirine Cmax, AUC and Cmin decreased by 9%, 10% and 10%, respectively. Atorvastatin Cmax and AUC increased by 35% and 4%, respectively; Cmin decreased by 15%. Cmax, AUC and Cmin of 2-hydroxy atorvastatin increased by 58%, 39% and 32%, respectively, whilst Cmax and AUC of 4-hydroxy atorvastatin increased by 28% and 23%, respectively.

van Heeswijk RPG, et al. The pharmacokinetic interaction between atorvastatin and TMC278, a next generation non-nucleoside reverse transcriptase inhibitor, in HIV-negative volunteers. 11th European AIDS Conference, Madrid, October 2007, abstract P4.3/04.

View all available interactions with Rilpivirine/ Emtricitabine/Tenofovir-DF (RPV/FTC/TDF) by clicking here.