Letermovir Injection and Pitavastatin: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Pitavastatin
Letermovir Injection
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Increased pitavastatin exposure and an increased risk for myopathy and rhabdomyolysis
Interaction Deep Dive
Concomitant use of letermovir and pitavastatin (OATP1B1/3 substrate and HMG-CoA reductase inhibitor) is not recommended as it may cause increased pitavastatin exposure and an increased risk of myopathy and rhabdomyolysis. In a drug interaction study, coadministration of letermovir (480 mg once daily orally) with a HMG-CoA reductase inhibitor, atorvastatin (20 mg single dose orally) led to increased AUC, Cmax and C24hr of atorvastatin by 229%, 117% and 262%, respectively1.
Why it happens (mechanism)
Inhibition of OATP1B1-mediated efflux transport of pitavastatin; inhibition of OATP1B3-mediated efflux transport of pitavastatin
Literature reports
1 report — tap to read
a) In a drug interaction study, coadministration of letermovir (480 mg once daily orally) with a HMG-CoA reductase inhibitor, atorvastatin (20 mg single dose orally) led to increased AUC, Cmax and C24hr of atorvastatin by 229%, 117% and 262%, respectively 1.
Common questions
Can I take Letermovir Injection and Pitavastatin together?
Increased pitavastatin exposure and an increased risk for myopathy and rhabdomyolysis Always confirm with your pharmacist or prescriber before making any change.
How serious is the Letermovir Injection and Pitavastatin interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Letermovir Injection or Pitavastatin need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (1)
- Product Information: PREVYMIS(R) oral tablets, oral pellets, intravenous injection, letermovir oral tablets, oral pellets, intravenous injection. Merck Sharp & Dohme Corp (per FDA), Rahway, NJ, 2024. DailyMed
Keep reading about Pitavastatin
Keep reading about Letermovir Injection
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