Lovastatin Drug Interactions

Like any other medication, there are several drugs that have to be avoided when taking lovastatin. These medications are known to cause adverse effects or interactions when used with lovastatin. Usually, these drugs affect the metabolism of the drug thereby increasing the risk for drug toxicity.

It is important to tell your doctor about any medications that you are taking, including vitamins, herbal products and dietary supplements, before beginning a lovastatin treatment.  Let your doctor know if you are currently taking, or have recently taken, any of the following medications or types of drugs:

Anti-arrythmic drugs

• amiodarone (Cordarone, Pacerone)

Antidepressants

• nefazodone (Serzone)

Blood thinners

• warfarin (Coumadin, Jantoven)

Calcium channel blockers

• verapamil (Calan, Isoptin, Verelan, Bosoptin)

Drugs for HIV/AIDS especially protease inhibitors

• amprenavir (Agenerase)
• darunavir (Prezista)
• fosamprenavir (Lexiva)
• indinavir (Crixivan)
• ritonavir (Norvir)
• tipranavir (Aptivus)

Immunosuppresive agents

• cyclosporine (Gengraf, Neoral, Sandimmune)

Fibrates

• fenofibrate (Antara,Lofibra, Tricor, Triglide)
• gemfibrozil (Lopid)

Nutritional supplements

• Niacin (Niacor, Nicolar)

Some antibiotics

• clarithromycin (Biaxin)
• erythromycin
• telithromycin (Ketek)

Some antifungals

• fluconazole (Diflucan)
• itraconazole (Sporanox)
• ketoconazole (Nizoral)
• miconazole
• posaconazole (Noxafil)
• voriconazole (VEEND)

Synthetic steroids

• danzol (Danocrine)

Some of these drugs increase the serum level of lovastatin to toxic levels thereby predisposing you to develop myopathy or serious muscle problems. If you experience sudden muscle tenderness, pain or weakness while on lovastatin, you should contact your physician immediately. Normally, you will need to undergo diagnostic test to check lovastatin serum levels.

In patients receiving cyclosporine, gemfibrozil, danazol, fibrates and niacin, the daily lovastatin dose should not be more than 20 mg. The same maximum daily dose is true for patients taking calcium channel blockers, diltiazem, and danazol. Meanwhile, patients taking amiodarone and verapamil must not take more than 40 mg lovastatin per day. Concomitant use of these drugs with high dose lovastatin increases the risk for kidney problems and muscle injury.

Antibiotics, anti-fungals, immunosuppressive drugs and HIV/AIDS drugs listed above tend to decrease the elimination of lovastatin thereby predisposing the patient to muscle toxicity from lovastatin. Patients taking this medication along with lovastatin treatment must be carefully monitored to avoid serious side effects.

Patients are also advised to avoid drinking large quantities of grapefruit juice which contains CYP450 3A4 inhibitors. This compound affects the metabolism and elimination of lovastatin hence can increase lovastatin drug levels.

How to prevent lovastatin drug interactions?

Inform your physician if you are using any of these drugs. Depending on your medical condition, your physician may recommend adjusting the dosage, changing lovastatin with other drugs or discontinuing use of lovastatin. Discuss with your physician the best course of action given your case.

You should also avoid drinking grapefruit or taking citrus fruits while on lovastatin. You can substitute grapefruit juice with other fruit juices that are compatible with lovastatin.

It is also important to avoid over-the-counter (OTC) drugs, herbal products, natural supplements and other health products while on lovastatin. Some of these health products have active ingredients that can interact with lovastatin. For your safety, it is best to contact your physician before taking any medication. It is also recommended that you avoid alcohol and alcohol-based beverages to prevent unwanted drug interactions.