Nelfinavir reduces pravastatin AUC by 46% in HIV negative volunteers
Mark Mascolini, HIVpharmacology.com
AIDS Clinical Trials Group (ACTG) researchers studied 18 HIV seronegative volunteers who took 40 mg of pravastatin daily for 3 days.
After 24-hour pharmacokinetic sampling on day 3, they stopped the statin and took 1250 mg of nelfinavir twice daily on days 4 through 12. They added pravastatin to the protease inhibitor on days 13 though 15 and gave 24-hour samples on day 16.
Median within-subject pravastatin area under the concentration-time curve dropped 46.5% when volunteers took the cholesterol-lowering drug with nelfinavir. Median maximum plasma concentrations of pravastatin fell from 27.9 ng/mL without nelfinavir to 12.4 ng/mL with nelfinavir. The median within-subject drop in pravastatin peak measured 40.1%.
The ACTG team concludes that higher doses of pravastatin may need to be prescribed [with nelfinavir] in order to achieve optimal lipid-lowering activity.
Judith A. Aberg, Susan L. Rosenkranz, Carl J. Fichtenbaum, Beverly L. Alston, Susan W. Brobst, Yoninah Segal, John G. Gerber, for the ACTG A5108 team. Pharmacokinetic interaction between nelfinavir and pravastatin in HIV-seronegative volunteers: ACTG Study A5108. AIDS 2006;20:725-729.