Non-prescription simvastatin in the UK: contraindicated with many HIV medications

Simon Collins, HIV i-Base

Mainstream press and TV items recently reported that Britain will soon become the first country to allow the sale of the cholesterol-lowering drug simvastatin (Zocor) without a prescription. This is in a move to cut the number of heart attacks and strokes. Low dose simvastatin will go on sale at pharmacies this year.

Simvastatin however is contraindicated for HIV patients who are on treatment because of significant interactions with indinavir, lopinavir, nelfinavir, ritonavir and saquinavir. There are also potential interactions with amprenavir, nevirapine, efavirenz and delavirdine.

Clinicians and pharmacists should ensure that patients with elevated cholesterol using these antiretroviral are aware that simvastatin is not an option for them.

Extensive drug-drug interaction charts are available on the excellent Liverpool University drug interaction website:

Links to other websites are current at date of posting but not maintained.