Interaction Checker
Potential Interaction
Lopinavir/ritonavir (LPV/r)
Atorvastatin
Quality of Evidence: High
Summary:
Coadministration of atorvastatin (20 mg once) and lopinavir/ritonavir (400/100 mg twice daily) had no significant effect on lopinavir (Cmax, AUC and Cmin decreased by 10%, 10% and 8%, respectively), but increased atorvastatin Cmax, AUC and Cmin by 4.7-fold, 5.9-fold and 2.3-fold, respectively. Coadministration is not recommended unless specifically required for patient management. Use the lowest possible dose of atorvastatin with careful monitoring (do not exceed a daily dose of 20 mg with careful safety monitoring.) or consider using other HMG-CoA reductase inhibitors such as pravastatin or fluvastatin in combination with lopinavir/ritonavir. (Note, American treatment guidelines recommend a maximum daily dose of 20 mg for atorvastatin.)
Description:
Coadministration increased atorvastatin AUC by 5.9-fold and Cmax by 4.7-fold due to CYP3A inhibition by Kaletra. The combination of Kaletra with atorvastatin is not recommended. If the use of atorvastatin is considered strictly necessary, the lowest possible dose of atorvastatin should be administered with careful safety monitoring. If treatment with a HMG-CoA reductase inhibitor is indicated, pravastatin or fluvastatin is recommended.
Kaletra Summary of Product Characteristics, AbbVie Ltd, January 2021.
Coadministration may increase atorvastatin concentrations. Use atorvastatin with caution and at the lowest necessary dose.
Kaletra Prescribing Information, AbbVie Ltd, October 2020.
Coadministration of atorvastatin (20 mg once daily for 4 days) and lopinavir (400/100 mg twice daily for 14 days) was studied in 12 healthy volunteers. Atorvastatin reduced plasma concentrations of lopinavir; ratios (with/without atorvastatin) for lopinavir Cmax, AUC and Cmin were 0.90, 0.90 and 0.92, respectively (1 = no effect). Lopinavir increased plasma concentrations of atorvastatin; ratios (with/without lopinavir) for atorvastatin Cmax, AUC and Cmin were 4.67, 5.88 and 2.28, respectively.
Concomitant administration of ABT-378/ritonavir results in a clinically important pharmacokinetic interaction with atorvastatin but not pravastatin. Carr TA, Andre AK, Bertz RJ, et al. 40th ICAAC, Toronto, September 2000, presentation 1644.
View all available interactions with Lopinavir/ritonavir (LPV/r) by clicking here.
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