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Recommendations for Managing Drug–Drug Interactions with Statins and HIV Medications

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Abstract

The discovery of antiretroviral therapy (ART) for the treatment of human immunodeficiency virus (HIV) has enabled individuals to live longer. As a result, HIV is now often considered a chronic condition. However, as a result of the increase in longevity or the HIV treatment modalities themselves, individuals with HIV are at high risk for the development of atherosclerotic cardiovascular disease. Therefore, these patients should be optimized with pharmacologic therapy to lower their cardiovascular risk through the addition of statin therapy to their regimen. Unfortunately, many medications utilized to treat HIV interact with this class of agents, making prescribing of statin therapy in these patients challenging. While several classes of ARTs do not pose an increased risk of drug–drug interactions with statins, HIV treatment often requires several combinations of medications, enhancing the complexity and drug–drug interaction risk. Clinicians should be aware of interactions with statins and ART and carefully review the degree and clinical significance of each particular medication. With this understanding, the appropriate statin as well as statin dose can be selected in order to optimize the treatment of this patient population, while minimizing the potential risk of adverse effects.

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Authors and Affiliations

  1. Department of Pharmacy Services, Medical University of South Carolina, Charleston, SC, USA

    Barbara S. Wiggins

  2. Kaiser Permanente of Colorado, Denver, CO, USA

    Donald G. Lamprecht Jr.

  3. University of Colorado Anschutz Medical Campus, Aurora, CO, USA

    Donald G. Lamprecht Jr., Robert L. Page II & Joseph J. Saseen

  4. South Carolina College of Pharmacy, 25 Courtenay Drive, MSC 584, Charleston, SC, 29425, USA

    Barbara S. Wiggins

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  1. Barbara S. Wiggins
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  2. Donald G. Lamprecht Jr.
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BS Wiggins has no conflicts of interest that might be relevant to the contents of this manuscript. DG Lamprecht has no conflicts of interest that might be relevant to the contents of this manuscript. RL Page has no conflicts of interest that might be relevant to the contents of this manuscript. JJ Saseen has no conflicts of interest that might be relevant to the contents of this manuscript.

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Wiggins, B.S., Lamprecht, D.G., Page, R.L. et al. Recommendations for Managing Drug–Drug Interactions with Statins and HIV Medications. Am J Cardiovasc Drugs 17, 375–389 (2017). https://doi.org/10.1007/s40256-017-0222-7

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