Drug Interactions between Pravachol and resmetirom

Consumer information for this interaction is not currently available.

ADJUST DOSE: Coadministration with resmetirom may increase the plasma concentrations and effects of the statins pravastatin and atorvastatin. The proposed mechanism is decreased clearance of the statin due to resmetirom-mediated inhibition of organic anion transporting polypeptides (OATP) 1B1/1B3 and breast cancer resistance protein (BCRP). Pravastatin, atorvastatin and the active metabolite atorvastatin lactone, are all substrates of OATP 1B1 and OATP 1B3. Atorvastatin and atorvastatin lactone are also substrates of BCRP. When healthy subjects taking resmetirom at steady state (100 mg daily) were administered a single dose of pravastatin (40 mg), the peak plasma concentration (Cmax) and systemic exposure (AUC) of pravastatin increased by 1.3 and 1.4-fold, respectively. Similarly, when healthy subjects taking resmetirom at steady state (100 mg daily) were administered a single dose of atorvastatin (20 mg), AUC of atorvastatin and atorvastatin lactone increased by 1.4 and 1.8- fold, respectively. No changes were observed in atorvastatin's Cmax, but the Cmax of atorvastatin lactone increased 2- fold. An increase in statin-related adverse effects may occur (e.g., myopathy and rhabdomyolysis).

MANAGEMENT: If concomitant use with resmetirom is required, the manufacturer advises a dose reduction of pravastatin and atorvastatin to a maximum recommended daily dosage of 40 mg. Closer monitoring for adverse effects such as myopathy and rhabdomyolysis may also be advised. Patients should be advised to promptly report unexplained muscle pain, tenderness, or weakness, particularly if accompanied by malaise or fever.