Pitavastatin, a newer statin, is metabolized primarily by glucuronidation rather than via the hepatic cytochrome P450 enzyme system, so it is expected to have fewer significant interactions with PIs than do other statins. To assess possible interactions between pitavastatin and lopinavir/ritonavir, an open-label, 2-way pharmacokinetic (PK) study was conducted with 24 HIV-uninfected subjects. Pitavastatin 4 mg QD was given on days 1-5 and 20-24, whereas lopinavir/ritonavir 400/100 mg BID was given on days 9-24. PK sampling was performed on days 5, 19, and 24.
Concurrent administration with lopinavir/ritonavir lowered the pitavastatin AUC by 20%, but there was no other significant change in any measured PK parameter (AUC, Cmax, T1/2) of pitavastatin, lopinavir, or ritonavir. Based on these data, pitavastatin may be coadministered with lopinavir/ritonavir without dosage adjustment.
1. Morgan R, Campbell S, Suehira K, et al. Effects of steady-state lopinavir/ritonavir on the pharmacokinetics of pitavastatin in healthy adult volunteers. In: Programs and abstracts of the 6th International AIDS Society Conference on HIV Pathogenesis, Treatment, and Prevention. July 17-20, 2011; Rome. Abstract MOPE170.