Lovastatin with Danazol Interaction Details
Brand Names Associated with Lovastatin
- Altocor®
- Altoprev®
- Lovastatin
- Mevacor®
Brand Names Associated with Danazol
- Danazol
- Danocrine®
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Nov 15, 2023
Interaction Effect
An increased risk of myopathy or rhabdomyolysis
Interaction Summary
The combination of danazol and lovastatin is associated with an increased risk of developing myopathy/rhabdomyolysis. A 91-year-old man, on long-term therapy with danazol, experienced rhabdomyolysis about 2 months after starting lovastatin . Risk of myopathy/rhabdomyolysis with concomitant lovastatin is dose-related, and coadministration should be used only if the potential benefit outweighs the risk. If used concomitantly with danazol, lovastatin therapy should be initiated with 10 mg daily, and should not exceed 20 mg daily . In addition, monitor the patient for signs and symptoms of myopathy or rhabdomyolysis (muscle pain, tenderness, weakness). Monitor creatine kinase (CK) levels and discontinue lovastatin use if CK levels show a marked increase, or if myopathy or rhabdomyolysis is diagnosed or suspected.
Severity
Major
Onset
Delayed
Evidence
Probable
How To Manage Interaction
The combination of danazol and lovastatin is associated with an increased risk of developing myopathy/rhabdomyolysis, especially with higher lovastatin doses, and should be used only if the potential benefit outweighs the risk. If used concomitantly with danazol, lovastatin therapy should be initiated with 10 mg daily, and should not exceed 20 mg daily . In addition, monitor the patient for signs and symptoms of myopathy or rhabdomyolysis (muscle pain, tenderness, weakness). Monitor creatine kinase (CK) levels and discontinue lovastatin use if CK levels show a marked increase, or if myopathy or rhabdomyolysis is diagnosed or suspected.
Mechanism Of Interaction
Inhibition of CYP3A4-mediated metabolism of lovastatin
Literature Reports
A) A 91-year-old man, on long-term therapy with danazol for idiopathic thrombocytopenia purpura, experienced rhabdomyolysis about 2 months after starting lovastatin. The patient was stabilized on danazol 400 mg once daily for the past 25 years and had received many different statins (fluvastatin, simvastatin, atorvastatin) in the last 10 years without recourse. About 2 months before presenting with symptoms, he had been switched from atorvastatin 10 mg/day to lovastatin 40 mg/day. At presentation, he reported bilateral leg weakness developing and worsening over the past 2 weeks. On examination, he had diffuse lower extremity weakness and skin ecchymosis without rash, but no other notable system involvement. Laboratory tests revealed elevated WBC (14,200 units/L), creatine kinase (22,504 units/L), liver enzymes (AST, 368 unit/L; ALT 415 units/L), and serum creatinine (2.5 mg/dL). Danazol and lovastatin were immediately discontinued, and he was treated with IV hydration and physical therapy. Within 4 days, laboratory values were normalizing and his symptoms improved. The Naranjo probability scale score of 8 indicated a probable causal association .
Lovastatin Overview
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Lovastatin 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. Lovastatin is also used to decrease the amount of cholesterol (a fat-like substance) and other fatty substances in the blood. Lovastatin is in a class of medications called HMG CoA reductase inhibitors (statins). It works by slowing the production of cholesterol in the body to decrease the amount of cholesterol that may build up on the walls of the arteries and block blood flow to the heart, brain, and other parts of the body.
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Accumulation of cholesterol and fats along the walls of your arteries (a process known as atherosclerosis) decreases blood flow and, therefore, the oxygen supply to your heart, brain, and other parts of your body. Lowering your blood level of cholesterol and fats with lovastatin may help prevent heart disease, angina (chest pain), strokes, and heart attacks.
Danazol Overview
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Danazol is used to treat endometriosis (a condition in which the type of tissue that lines the uterus [womb] grows in other areas of the body and causes infertility, pain before and during menstrual periods, pain during and after sexual activity, and heavy or irregular bleeding)..Danazol is also used to treat fibrocystic breast disease (swollen, tender breasts with noncancerous lumps) when other treatments are not successful. Danazol is also used to prevent attacks in people with hereditary angioedema (inherited condition that causes episodes of swelling in the hands, feet, face, airway, or intestines). Danazol is in a class of medications called androgenic hormones. It works to treat endometriosis by shrinking the displaced tissue of the uterus. It works to treat fibrocystic breast disease by blocking the release of hormones that cause the breast pain and lumps. It works to treat hereditary angioedema by increasing the amount of a natural substance in the body.
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Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
Where Does Our Information Come From?
Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.