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Interactions médicamenteuses

Atazanavir + Red yeast rice

Gravité: Majeure

Atazanavir and Red yeast rice: major interaction.

Dernière mise à jour

Réservé aux professionnels de santé — à titre de référence uniquement. Cette page est un bref résumé, pas un avis médical, et ne remplace ni la notice officielle ni le jugement clinique. Vérifiez toujours avant de prescrire ou de délivrer.

Le contenu clinique de cette page n'est disponible qu'en anglais.

Résumé

Red yeast rice contains monacolin K, which is chemically identical to lovastatin, a CYP3A4 substrate. Atazanavir, boosted or not, is a strong CYP3A4 inhibitor and can greatly increase monacolin K exposure, raising the risk of myopathy and rhabdomyolysis.

Ce que signifie cette interaction, en termes simples

Atazanavir and Red yeast rice can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.

Atazanavir belongs to Anti Virals; Red yeast rice belongs to Gastrointestinal Tract.

Niveau de preuve: Moderate

Pourquoi elle survient

Atazanavir inhibits CYP3A4, reducing first-pass and systemic clearance of monacolin K (lovastatin).

Conduite à tenir

Avoid the combination and use a statin with a lower CYP3A4 dependence, such as pravastatin or rosuvastatin, at a suitable dose. Counsel the patient to report muscle pain or dark urine.

Questions à poser à votre pharmacien

  • Does the benefit of taking both outweigh the risk in my case?
  • Do I need any blood test, ECG or other check while on both?
  • What early warning signs should I watch for, and what should I do if they appear?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Questions fréquentes

Can I take Atazanavir with Red yeast rice?

MediHelp rates the interaction as major. Atazanavir and Red yeast rice can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Red yeast rice contains monacolin K, which is chemically identical to lovastatin, a CYP3A4 substrate. Atazanavir, boosted or not, is a strong CYP3A4 inhibitor and can greatly increase monacolin K exposure, raising the risk of myopathy and rhabdomyolysis.

How serious is the interaction between Atazanavir and Red yeast rice?

MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination and use a statin with a lower CYP3A4 dependence, such as pravastatin or rosuvastatin, at a suitable dose. Counsel the patient to report muscle pain or dark urine.

What other medicines interact with Red yeast rice?

MediHelp also lists interactions of Red yeast rice with, for example, Ritonavir, Saquinavir, Tipranavir. The full list is on the Red yeast rice page.

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Ouvrez le référentiel complet, vérifiez les interactions entre plusieurs médicaments et utilisez les outils de posologie dans l'application MediHelp.

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