Simvastatin Efavirenz

Efavirenz (Sustiva) [Antiretroviral/NNRTI] Uses Hiv infxns Action Antiretroviral nonnucleoside RTI Dose Adults. 600 mg/d PO qhs Feds. See package insert avoid high-fat meals Caution [D, ] CDC recommends HIV-infected mothers not breast-feed Contra Component sensitivity Disp Caps SE Somnolence, vivid dreams, dizziness, rash, N/V/D Interactions T Effects W/ ritonavir T effects OF CNS depressants, ergot derivatives, midazolam, ritonavir, simvastatin, triazolam, warfarin X effects W/ carbamazepine, phenobarbital, rifabutin, rifampin, saquinavir, St. John s wort i effects OF amprenavir, carbamazepine, clarithromycin, indinavir, phenobarbital, saquinavir, warfarin may alter effectiveness OF OCPs EMS Concurrent EtOH usage can t CNS d ression OD May cause muscle contractions and adverse CNS effects activated charcoal may be effective... 

STATINS NNRTIs 1 levels of atorvastatin, pravastatin and simvastatin with efavirenz Uncertain efavirenz is known to induce intestinal P-gp, which may 1 the bioavailability of some statins (including atorvastatin) Monitor lipid profile closely... 

Delavirdine is expected to raise the levels of atorvastatin, simvastatin and lovastatin. This expectation is supported by a case of rhabdomyolysis, which developed in a patient taking atorvastatin and delavirdine. Efavirenz (and possibly nevirapine) lower the levels of atorvastatin, simvastatin, and pravastatin. 

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