HIV and HCV protease inhibitors should never be taken (are contraindicated) with lovastatin (Mevacor) and simvastatin (Zocor) (see Statin Dose Limitations below). Simvastatin is used together with diet, weight-loss, and exercise to reduce the risk of heart attack and stroke and to decrease the chance that heart surgery will be needed in people who have heart disease or who are at risk of developing heart disease. Simvastatin is in a group of drugs called HMG CoA reductase inhibitors, or statins. It reduces levels of bad cholesterol (low-density lipoprotein, or LDL) and triglycerides in the blood, while increasing levels of good cholesterol (high-density lipoprotein, or HDL). In general, the potential for inhibition of statin metabolism is as follows: simvastatin and lovastatin atorvastatin and rosuvastatin pravastatin. Interactions of PIs with fluvastatin and pitavastatin have not been studied thoroughly. HIV is essentially a chronic disease, and individuals with HIV are at high risk for cardiovascular events. Dyslipidemia is common in patients with HIV and is characterized by increases in total cholesterol, triglycerides, and low-density lipoprotein cholesterol and decreases in high-density lipoprotein cholesterol. DRUG INTERACTIONS BETWEEN ANTIRETROVIRAL AGENTS AND LIPID-LOWERING THERAPY. The Food and Drug Administration (FDA) has approved 25 agents among five classes of antiretroviral therapy for the treatment of HIV (Table 1). 1 Drug Interactions with HIV and Psychiatric Medications John J Faragon, PharmD, BCPS, AAHIV-P Regional Pharmacy Director, NY/NJ AETC Pharmacist, Albany Medical Center Simvastatin Extensively metabolized by CYP 3A4. PIs: substantial ↑ in simvastatin levels, high risk of adverse effects (eg, simvastatin Cmax and AUC ↑ 3,000% with SQV + RTV). Genvoya (elvitegravir, cobicistat, emtricitabine, and tenofovir alafenamide) is used to treat HIV infection. Includes Genvoya side effects, interactions and indications. Statins are a class of drugs used to treat high lipids, especially high LDL cholesterol. They include simvastatin (Zocor), pravastatin (Lipostat), fluvastatin (Lescol / Lescol XL), atorvastatin (Lipitor) and rosuvastatin (Crestor).