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Cholesterol Lowering Drugs and HAART
Feb 25, 2001

Hello, and first, thanks to you all for a continuing great job. This is the best HIV website out there. I have been on HAART since Aug., 1999. Before that I used pravachol to sucessfully control my cholesterol level for at least ten years. After starting HART, I discontinued the pravachol. My latest blood test shows total cholesterol at 297, the bad (LDL) at 194, the good at 39 and triglycerides at 320. To bring them back into acceptable ranges, it has been recommended that I start using pravachol again. I am currently on videx EC, combivir, crixivan and norvir, since Nov., 2000. What is your reaction to adding pravachol? Thanks. Gary

Response from Dr. Cohen

Thanks - glad this site helps.

Your choice of pravachol is amongst the safest to pick for those also on ritonavir/norvir. There have been studies done of antivirals and the "statins". And they show, in general, that there is little interaction with pravachol and ritonavir (if anything there may be a small decrease in the pravachol levels, meaning you might need higher than expected doses to regain control of the cholesterol.) The other "statin" that can be used is atorvastatin - or Lipitor. It has only some boosting by the norvir - and so can be used safely, especially when started at lower doses and work up slowly if needed. The main one to avoid is lovastatin and Zocor - since they would have levels that could be dangerously high.

It is certainly reasonble to restart the pravachol. It should have some impact - although we are still learning about the best ways to reestablish a normal cholesterol for those on the PI meds.

CC



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