Drug General Information (ID: DDIYH4SQ07)
Drug Name			Indinavir		Drug Info		Rosuvastatin		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Anti-Hiv Agents				Statins/Antihyperlipidemic Agents
Structure

Mechanism of Indinavir-Rosuvastatin Interaction (Severity Level: Major)
Decreased metabolism (Unspecific) Click to Show/Hide Mechanism Graph
Drug Name		Indinavir				Rosuvastatin
Mechanism		Increase the plasma concentrations of rosuvastatin				Rosuvastatin
Key Mechanism Factor 1
		Factor Name		Pharmacokinetics
		Factor Description		Alters the metabolism of the drug, leading to changes in the plasma concentration of the drug and affecting the pharmacological effects.
Mechanism Description		Decreased metabolism of Rosuvastatin caused by Indinavir

Recommended Action
Management		Rosuvastatin may be used with caution and close monitoring in patients treated with indinavir, although the lowest possible dosage should be used. Fluvastatin, pitavastatin, and pravastatin may be safer alternatives, since they are not metabolized by CYP450 3A4. All patients receiving statin therapy should be advised to promptly report any unexplained muscle pain, tenderness or weakness, particularly if accompanied by fever, malaise and/or dark colored urine. Therapy should be discontinued if creatine kinase is markedly elevated in the absence of strenuous exercise or if myopathy is otherwise suspected or diagnosed.

References
1	Cerner Multum, Inc. "UK Summary of Product Characteristics.".
2	Product Information. Crixivan (indinavir). Merck &amp Co, Inc, West Point, PA.
3	Shelton MJ, Wynn HE, Newitt RG, DiFrancesco R "Effects of grapefruit juice on pharmacokinetic exposure to indinavir in HIV-positive subjects." J Clin Pharmacol 41 (2001): 435-42. [PMID: 11304900]