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Statin choice with ciclosporin — GPhC CRA MCQ

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HardCardiovascular TherapeuticsStatin choice with ciclosporinGPhC CRA

A renal transplant patient taking ciclosporin 75mg twice daily is prescribed simvastatin 40mg at night after a lipid review. His eGFR is 52mL/min/1.73m2 and ALT is within range. The GP asks the pharmacy to suggest a safer lipid-lowering option. What is the most appropriate alternative?

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Correct answer: C — Pravastatin at a cautious dose with specialist agreement

Ciclosporin markedly increases exposure to several statins and raises the risk of myopathy and rhabdomyolysis. Simvastatin is contraindicated with ciclosporin, and high-dose atorvastatin or rosuvastatin would be unsafe. Pravastatin may be used cautiously at an appropriate dose with specialist input. Lipid response and adverse effects still require follow-up.

Reference: BNF; Summary of Product Characteristics