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Author Topic: statin safe for my combination?  (Read 2420 times)

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Offline SouthSam7

  • Member
  • Posts: 428
statin safe for my combination?
« on: June 26, 2008, 10:27:55 PM »
I searched "statin" in the forums and didn't find anything recent, so I'm starting a new topic:

I can't afford Crestor anymore.  It's non-preferred so I pay a huge amount every month for it.

What statins are safe with Norvir, Invirase and Truvada?  What do most of you all use?  I looked on aidsmeds.com and didn't find any "recommended" statin(s).  I know there are a couple I shouldn't take because of my hiv meds, but I don't know which ones.

I know there are some generic ($4-$15 a month) statins but I don't know anything about them or which ones they are.

I want to have this information with me when I approach my doc about the reason for me needing to switch.

Thanks,

Sam

Offline YaKaMein

  • Member
  • Posts: 368
Re: statin safe for my combination?
« Reply #1 on: June 26, 2008, 10:54:59 PM »
hey Sam,
Been on Lipitor 10mg once daily for a few months. Saw a reduction of cholesterol with last labs, no decrease with triglycerides. Won't know til next labs in a few weeks. If needed, your ASO may be able to assist you obtaining patient prescription assistance for some of your meds.

Regarding some drugs for lipid management, I found this:

http://www.aidsmeds.com/articles/Hyperlipidemia_4815.shtml
09/11 Endocrine Consult
08/11 CD4 328 14.9% VL 0
 Disc'd Bactrim DEXA -3.1 Tscore
03/11 CD4 338 14.7% VL 0
11/10 CD4 300 14.3% VL 0 <20copies
07/10 CD4 336 14.0% VL 0 DEXA -2.7 Tscore
03/10 CD4 308 13.4% VL 0 Vit D normal
01/10 Began FOTO
11/09 CD4 274 13.7% VL 0 Chol 173 Trig 131
07/09 CD4 324 13.5% VL 0 DEXA -3.1 Tscore lumbar
03/09 CD4 207 10.9% VL 0
11/08 CD4 227 10.3% VL 0 Chol 176 Trig 156
04/08 CD4 228 9.5% VL 0
01/08 CD4 194 9.0% VL 0
09/07 CD4 176 8.3% VL 0
03/07 CD4 130 9.5% VL 0 Chol 261  Trig 227
12/06 CD4 109 6.4% VL 0
09/06 CD4  88 5.5% VL und desens'd rtd to Bactrim
08/06  Began Atripla
07/06 CD4  59 5.0% VL 145 Chol 117 Trig 104
06/06  Bactrim rash, X2 Dapsone
 EFV & Truvada Chol 128 Trig 131
05/06 CD4  6 (2.0%) VL 78667 only V179D mutation Dx PC MAC

Offline SouthSam7

  • Member
  • Posts: 428
Re: statin safe for my combination?
« Reply #2 on: June 26, 2008, 11:37:42 PM »
Thanks, YaKaMein.  Don't forget, I'm on PIs, one or both are contraindicated for certain statins.

I'll check out the link you gave.  Thanks!

Offline Assurbanipal

  • Member
  • Posts: 2,173
  • Taking a forums break, still see PM's
Re: statin safe for my combination?
« Reply #3 on: June 28, 2008, 12:31:31 AM »
Hi Sam

You might want to research Pravastatin (the generic form of Pravachol).  Looks like the interaction guide available under the cool tools indicates that it may not be as effective in the presence of norvir but is not usually unsafe.  And if it works for you it is available on the cheap Walmart/Target low co-pay drug formularies.

Lipitor is not expected to be available in generic form until 2010 or 2011 and a lot of the drug plans are charging high co-pays for it now (it's on a lot of non-preferred lists).  Most of the drug plans are pushing zocor's generic as a replacement for lipitor, but zocor is one of the statins that has bad interactions with many HAART drugs, so that's not an option for most of us here.

Regards
A
5/06 VL 1M+, CD4 22, 5% , pneumonia, thrush -- O2 support 2 months, 6/06 +Kaletra/Truvada
9/06 VL 3959 CD4 297 13.5% 12/06 VL <400 CD4 350 15.2% +Pravachol
2007 VL<400, 70, 50 CD4 408-729 16.0% -19.7%
2008 VL UD CD4 468 - 538 16.7% - 24.6% Osteoporosis 11/08 doubled Pravachol, +Calcium/D
02/09 VL 100 CD4 616 23.7% 03/09 VL 130 5/09 VL 100 CD4 540 28.4% +Actonel (osteoporosis) 7/09 VL 130
8/09  new regimen Isentress/Epzicom 9/09 VL UD CD4 621 32.7% 11/09 VL UD CD4 607 26.4% swap Isentress for Prezista/Norvir 12/09 (liver and muscle issues) VL 50
2010 VL UD CD4 573-680 26.1% - 30.9% 12/10 VL 20
2011 VL UD-20 CD4 568-673 24.7%-30.6%
2012 VL UD swap Prezista/Norvir for Reyataz drop statin CD4 768-828 26.7%-30.7%

Offline SouthSam7

  • Member
  • Posts: 428
Re: statin safe for my combination?
« Reply #4 on: June 28, 2008, 04:09:43 PM »
Since I last wrote, I did some homework:

My doc was ready to switch me to Lipitor.  When I called the Mail order pharmacy in bed with my insurance company, I also asked about crestor.

It turns out that, while 10 mg crestor is $60 for one month (same as local pharmacy), the 20 mg dose is available for $60 for 90 DAYS.  When I told my doc this, she wrote a scrip for 20 mg dose and told me to split it.

The bottom line: what cost me $720 a year before will now cost me $120 a year.

Thanks, everyone for your help.  I suspect when Lipitor goes generic (you can get it generic already thru canada) I will switch.  That's a no-brainer ($4 a month).

Offline aztecan

  • Member
  • Posts: 5,394
  • 29 years positive, 57 years a pain in the butt
Re: statin safe for my combination?
« Reply #5 on: June 29, 2008, 10:33:02 AM »
Hey Sam,

Glad you found a solution. Regarding switching to Lipitor, make sure you check with your doc and keep an eye out for side effects. You should with any statin.

The side effects can include sore, aching muscles, muscle cramps, weakness in your muscles, and they can get worse with time.

I took Vytorin, which is a combo of Zocor and Zetia, but had side effects within a few weeks.

I switched to Pravastatin (generic Pravachol), which did pretty well, but just had to stop taking it and Zetia becasue I again developed side effects.

In my case, statins are pretty much out of the picture now.

My doctor ordered me to stop taking all of them, wait a few weeks and then get more blood tests done to make sure things are recovering. The last thing I want is to have a heart attack caused by the medication that is supposed to help me prevent a heart attack.

If all goes well, I will be on Niaspan in a few weeks. I hope it works and doesn't cause too any problems.

Hang in there.

HUGS,

Mark
« Last Edit: June 29, 2008, 12:05:21 PM by aztecan »
"May your life preach more loudly than your lips."
~ William Ellery Channing (Unitarian Minister)

Offline YaKaMein

  • Member
  • Posts: 368
Re: statin safe for my combination?
« Reply #6 on: June 29, 2008, 10:58:17 AM »
Sam, that's a great solution. It keeps your treatment continuity at a cost you can afford.

Mark, keep us abreast of the Niaspan. _YaKa
09/11 Endocrine Consult
08/11 CD4 328 14.9% VL 0
 Disc'd Bactrim DEXA -3.1 Tscore
03/11 CD4 338 14.7% VL 0
11/10 CD4 300 14.3% VL 0 <20copies
07/10 CD4 336 14.0% VL 0 DEXA -2.7 Tscore
03/10 CD4 308 13.4% VL 0 Vit D normal
01/10 Began FOTO
11/09 CD4 274 13.7% VL 0 Chol 173 Trig 131
07/09 CD4 324 13.5% VL 0 DEXA -3.1 Tscore lumbar
03/09 CD4 207 10.9% VL 0
11/08 CD4 227 10.3% VL 0 Chol 176 Trig 156
04/08 CD4 228 9.5% VL 0
01/08 CD4 194 9.0% VL 0
09/07 CD4 176 8.3% VL 0
03/07 CD4 130 9.5% VL 0 Chol 261  Trig 227
12/06 CD4 109 6.4% VL 0
09/06 CD4  88 5.5% VL und desens'd rtd to Bactrim
08/06  Began Atripla
07/06 CD4  59 5.0% VL 145 Chol 117 Trig 104
06/06  Bactrim rash, X2 Dapsone
 EFV & Truvada Chol 128 Trig 131
05/06 CD4  6 (2.0%) VL 78667 only V179D mutation Dx PC MAC

Offline SouthSam7

  • Member
  • Posts: 428
Re: statin safe for my combination?
« Reply #7 on: June 29, 2008, 12:45:17 PM »
Thanks, guys.

My mom takes Niaspan, since statins were raising her liver enzymes too much.  She takes it along with Zetia.  I've told her about the recent study showing that Zetia does not work, but she keeps taking it.

The niacin (Niaspan) has really lowered her cholesterol.  Good luck.

Now if I could just get rid of my headaches... (hijack warning!)

Sam

BobF

  • Guest
Re: statin safe for my combination?
« Reply #8 on: July 01, 2008, 12:28:38 PM »
Hi Guys.   I hope you are successful with Niaspan, too.   It's been added to my regimen (500mg Niaspan ER) along with 40mg of Crestor and Gemfibrozil.   My cholesterol and triglycerides were stubbornly high until the Niaspan was added and I'm now in the therapeutic range my Docs want.  The only suggestion I have is to make sure to take an aspirin about 30 minutes before the Niaspan to avoid the "flushing" problem that it's known to cause.   I do this and haven't had any issues with it at all.

Good luck!
Bob

Offline Anna Karenina

  • Member
  • Posts: 32
Re: statin safe for my combination?
« Reply #9 on: July 24, 2008, 09:29:36 AM »
AZTECAN have you talked to your doctor about fish oil supplements as an alternative to statins?  Let me preface by saying I hold a deep-seated suspicion and cynicism (brainwashed no doubt) for any drug/supplement that is even SLIGHTLY alternative or natural but you cant argue with controlled studies!!  The omega-3 supplements have demonstrated an ability to reduce triglycerides, increase the good HDL cholesterol and has a blood thinning effect - they don't work as well as statins, but it is a good alternative for people who are for whatever reason unable and unwilling to take statins.  If you are interested in this have a talk to your doctor to check for any possible bad interactions with your meds. 

p.s if you do start taking them, whatever you do don't accidentally bite the squishy capsule, if you do and the 'fish juice' spurts out into your mouth you will spend the next ten minutes washing the highly concentrated dead fish taste out of your mouth out with anything you can find, including soap.  (speak from personal experience lol)   

Offline aztecan

  • Member
  • Posts: 5,394
  • 29 years positive, 57 years a pain in the butt
Re: statin safe for my combination?
« Reply #10 on: July 24, 2008, 07:49:34 PM »
Hey Anna,

Yep, I take 6 grams (6,000 milligrams) of fish oil a day. That is max the doc said I can safely take.

It does seem to keep the triglycerides in check, well, mostly.

HUGS,

Mark
"May your life preach more loudly than your lips."
~ William Ellery Channing (Unitarian Minister)

Offline SouthSam7

  • Member
  • Posts: 428
update - statin safe for my combination?
« Reply #11 on: July 25, 2008, 12:39:36 AM »
Well when I actually had my doc call the rx in to the mail order company, it would be 300 bucks for three months.  So I found an alternate source for Crestor generic: $78 for a year.  I don't have to stress about it for a year

 


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