Livalo Drug Interactions

by on April 19, 2012

Livalo (pitavastatin) may interact with other drugs that use the same metabolic pathways.  Hence their concurrent use must be avoided or monitored.

Some medications that have known interaction with Livalo include the following:

Antigout agents

  • colchicine (Colcrys)

Blood thinners

  • warfarin (Coumadin, Jantoven)

Livalo potentiates the effects of warfarin hence patients taking warfarin may experience increased risk for bleeding. Close medical supervision is necessary when taking these drugs together.

Drugs for HIV/AIDS especially protease inhibitors

  • amprenavir (Agenerase)
  • atazanavir (Reyataz)
  • darunavir (Prezista)
  • fosamprenavir (Lexiva)
  • indinavir (Crixivan)
  • lopinavir and ritonavir (Kaletra)
  • nelfinavir (Viracept)
  • saquinavir (Fortovase, Invirase)
  • ritonavir (Norvir)
  • tipranavir (Aptivus)

Erectile dysfunction drugs

  • sildenafil (Revatio, Viagra)


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

Immunosuppresive agents

cyclosporine (Gengraf, Neoral, Sandimune)

Nutritional supplements

  • niacin (Niacor, Nicolar)

Some antibiotics

  • clarithromycin (Biaxin)
  • daptomycin (Cubicin)
  • erythromycin
  • rifampin
  • telithromycin (Ketek)

Other antilipidemic agents (statins)

Patients taking other statin agents must also be closely monitored for potential side effects particularly serious muscle problems. In general, concurrent use of different statins is not recommended.  These include:

  • atorvastatin (Lipitor)
  • fluvastatin (Lescol, Lescol XL)
  • lovastatin (Altoprev, Mevacor)
  • pravastatin (Pravachol)
  • rosuvastatin (Crestor)
  • simvastatin (Zocor)
  • other antilipidemic preparations such as Advicor, Caduet, Juvisyn, Vytorin, and Simcor

Colchicine, daptomycin, erythromycin, protease inhibitors, rifampin, and sildenafil tend to increase the blood levels of Livalo. Use of these drugs along with Livalo can produce unpredictable results. Clinical trials suggest that combining these drugs increases the person’s risk for developing side effects especially muscle problems that include rahabdomyolysis and myopathy. It is important that you inform your physician if you are taking any of these drugs. Also, contact your physician immediately if you experience muscle pain, tenderness or weakness while on this drug.

Usually, physicians adjust the dose of Livalo when taken along with these drugs. For example, patients taking erythromycin should not take more than 1 mg of Livalo per day while patients on rifampin should not take more than 2 mg of Livalo per day. These two drugs are known to interact with Livalo hence the dosage is kept at the lowest possible. Be sure to talk to your physician before using these drugs while on Livalo treatment.

Patients taking cyclosporine should not take Livalo since this drug can significantly increase the action of pitavastatin. Use of Livalo along with fibrates and niacin increases the potential for experiencing serious muscle problems, as such must be taken with much caution.

Some over-the-counter products can also negatively affect the effectiveness of Livalo (pitavastatin). Talk to your doctor about any nonprescription health product you may be using, or planning to use, including herbal products, vitamins and nutritional supplements.