HIV/AIDS Drug-Drug Interaction: Pravastatin and nelfinavir coadministration reduces pravastatin plasma levels

AIDSWEEKLY Plus; Monday, May 29, 2006
Staff Medical Writers

According to a study from the United States, "Nelfinavir, an HIV protease inhibitor with numerous drug-drug interactions, is associated with dyslipidemia. Pravastatin is the preferred statin prescribed for HIV-associated dyslipidemia."

"To examine the effect of nelfinavir on pravastatin pharmacokinetics," an open-label "study in healthy HIV-seronegative adults" was "conducted at the AIDS Clinical Trials Group sites in the United States."

"Subjects received pravastatin 40 mg daily and underwent intensive sampling for pharmacokinetics on day 3. Subjects took only nelfinavir 1250 mg twice daily on days 4-12. On days 13-15, subjects continued nelfinavir and reinitiated pravastatin.

"Plasma samples were collected over 24 hours for the calculation of pravastatin area under the concentration-time curve for 0-24 hours on days 3 and 16. Data from 14 subjects with complete pharmacokinetic samples were available for analysis," wrote J.A. Aberg and colleagues at New York University.

Investigators reported, "The median within-subject percentage change in pravastatin AUC was a decrease of 46.5%. Pravastatin maximum plasma concentrations were also lower when pravastatin was administered with nelfinavir.

"Median values for the maximum plasma concentrations were 27.9 and 12.4 ng/mL for days 3 and 16, respectively, and the median within-subject decrease was 40.1%. Coadministration of pravastatin and nelfinavir led to a substantial reduction in pravastatin plasma concentrations."

"Higher doses of pravastatin may need to be prescribed in order to achieve optimal lipid-lowering activity," the authors concluded.

Aberg and colleagues published the results of their research in AIDS (Pharmacokinetic interaction between nelfinavir and pravastatin in HIV-seronegative volunteers: ACTG study A5108. AIDS. 2006 Mar 21;20(5):725-9).

For additional information, contact J.A. Aberg, New York University, 550 1st Avenue, room 558, Bellevue C&D Bldg, New York City, NY 10016, USA.

The publisher of the journal AIDS can be contacted at: Lippincott Williams & Wilkins, 530 Walnut St., Philadelphia, PA 19106-3621, USA.

Keywords: New York, New York, United States, HIV/AIDS, Drug Interactions, Nelfinavir, Pharmacokinetics, Pravastatin.

This article was prepared by AIDS Weekly editors from staff and other reports.

Reference

Aberg JA, Rosenkranz SL, Fichtenbaum CJ, et al., "Pharmacokinetic interaction between nelfinavir and pravastatin in HIV-seronegative volunteers: ACTG Study A5108", AIDS. 2006 Mar 21;20(5):725-9. [ Full-text]

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