Kaletra and Zypitamag

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Using pitavastatin together with lopinavir is not recommended. Combining these medications may significantly increase the blood levels of pitavastatin. This can increase the risk of side effects such as liver damage and a rare but serious condition called rhabdomyolysis that involves the breakdown of skeletal muscle tissue. In some cases, rhabdomyolysis can cause kidney damage and even death. Let your doctor know immediately if you have unexplained muscle pain, tenderness, or weakness while taking pitavastatin, especially if these symptoms are accompanied by fever or dark colored urine. You should also seek immediate medical attention if you develop fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, dark colored urine, and/or yellowing of the skin or eyes, as these may be signs and symptoms of liver damage. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

GENERALLY AVOID: Coadministration with lopinavir-ritonavir may significantly increase the plasma concentrations of pitavastatin. The mechanism of interaction has not been described. The proposed interaction is based on data with another HMG-CoA reductase inhibitor that has a similar pharmacokinetic profile to that of pitavastatin. In 15 healthy volunteers, administration of rosuvastatin (20 mg once a day) in combination with lopinavir-ritonavir (400 mg-100 mg twice a day) for 7 days was associated with an approximately 5-fold increase in rosuvastatin steady-state peak plasma concentration (Cmax) and a 2-fold increase in systemic exposure (AUC) compared to administration of rosuvastatin alone. One subject had asymptomatic creatine phosphokinase elevation 17 times the upper limit of normal (ULN) and another had liver function test elevation between 1.1 and 2.5 times the ULN during treatment with the combination. Although not reported in the study, high levels of HMG-CoA reductase inhibitory activity in plasma is also associated with an increased risk of musculoskeletal toxicity. Myopathy manifested as muscle pain and/or weakness associated with grossly elevated creatine kinase exceeding ten times the upper limit of normal has been reported occasionally. Rhabdomyolysis has also occurred rarely, which may be accompanied by acute renal failure secondary to myoglobinuria and may result in death.

MANAGEMENT: The use of pitavastatin in combination with lopinavir-ritonavir is not recommended. An alternative such as fluvastatin or pravastatin may be considered.

Kaletra

Generic Name: lopinavir / ritonavir

Brand name: Kaletra

Synonyms: n.a.

What is Kaletra?

Zypitamag

Generic Name: pitavastatin

Brand name: Livalo, Zypitamag

Synonyms: n.a.

What is Zypitamag?