The levels of
atorvastatin appear to be markedly increased by darunavir/ritonavir,
lopinavir/ritonavir, nelfinavir, and saquinavir/ritonavir. The manufacturers of ataza- navir/ritonavir and
amprenavir state that they may also increase
atorvastatin levels.
It is generally recommended that
atorvastatin is used at low doses (i.e. 10 mg) and with care in patients taking
protease inhibitors. Patients should be counselled regarding myopathy (e.g. report any unexplained muscle pain, tenderness or weakness). The manufacturers of
atazanavir and
tipranavir advise avoiding concurrent use.