Volume 1, Issue 37, 09/29/2009
Why is lovastatin (Mevacor®) absolutely contraindicated in human immunodeficiency virus (HIV) infected patients taking protease inhibitor (PI) based highly active antiretroviral therapy (HAART)?
The HMG CoA reductase inhibitor (i.e., statin) medication lovastatin (Mevacor®) is used for the treatment of hypercholesterolemia.(1) While it is not used as much in clinical practice compared to other statins, its use is possible for the following reasons, 1) lovastatin is available as a generic medication on the market, 2) patients may have limited medical insurance or access to medical care where the use of cheaper medications could be used or sought after, and 3) some patients may self medicate by purchasing medications available in other countries without a prescription. As it relates to patients with human immunodeficiency virus (HIV)-infection that are being treated with a protease inhibitor (PI) based highly active antiretroviral therapy (HAART), numerous guidelines and medical sources indicate that lovastatin is contraindicated with the use of all PIs.(1-5) However, the use of lovastatin with non-nucleoside reverse transcriptase inhibitors (NNRTIs), with the exception delavirdine (a drug rarely used in routine clinical practice), is generally considered...
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