Question
What can I do about my high cholesterol levels?
30 October 2009. Related: All topics, Changing treatment, Drug interactions.
As I have had adverse side effects to three separate cholesterol lowering drugs in the past two years and life style changes alone offer only limited benefits to my persistent high cholesterol levels (8.5 +), my consultant is keen for me to switch from efavirenz to etravirine. I am reluctant to change to this drug as there has been a new side effect warnings added by manufacturer in August 2009 and I can find no evidence to suggest that this drug would benefit my high cholesterol levels. I also take medication for high blood pressure. Any suggestions?
Answer
Firstly, etravirine should be used with caution with statins, such as atorvastatin, rosuvastatin, or simvastatin. If you are taking a statin in combination with etravirine, your cholesterol levels should be regularly monitored to make sure the statin is still producing an effect. Your doctor may need to adjust your statin dose. Pravastatin is the statin that is not expected to be affected by etravirine.
All of the above is if you agree to go on etravirine.
Have you considered nevirapine (to possibly increase the good cholesterol) instead? The effect of abacavir on cholesterol is quite good too, but as you have a high blood pressure and most probably you have a high cardiovascular risk, then it may not be a very good idea, but still a discussion of the pluses and minuses with your doctor may be useful.
There is some general information and recommendations for a case like yours here. Hope you will find them useful.
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