CriticalAntiretroviral, HIV protease inhibitor×HMG-CoA reductase inhibitors (statins)
Updated · Methodology
Mechanism
Atazanavir inhibits CYP3A4. Simvastatin rises 10+ fold – fatal rhabdomyolysis.
Symptoms
Myalgia, dark urine within 5-10 days.
Management
Combination contraindicated. Switch to pravastatin or rosuvastatin.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.
Summary of a multi-drug list →
Medicine list: everything you take in one place →
Sources
- EMA: Reyataz (atazanavir) SmPC (2024)– EMA EPAR Reyataz
- AEMPS: Ficha técnica: Simvastatina (nº registro 65199), sección 4.3 (2026)– AEMPS, CIMA, nº registro 65199, revisión 03/2026, sección 4.3