Drug interactions and the statins

Herman, Robert J.
November 1999
CMAJ: Canadian Medical Association Journal;11/16/99, Vol. 161 Issue 10, p1281
Academic Journal
AbstractDrug interactions commonly occur in patients receiving treatment with multiple medications. Most interactions remain unrecognized because drugs, in general, have a wide margin of safety or because the extent of change in drug levels is small when compared with the variation normally seen in clinical therapy. All drug interactions have a pharmacokinetic or pharmacodynamic basis and are predictable given an understanding of the pharmacology of the drugs involved. Drugs most liable to pose problems are those having concentration-dependent toxicity within, or close to, the therapeutic range; those with steep dose-response curves; those having high first-pass metabolism or those with a single, inhibitable route of elimination. Knowing which drugs possess these intrinsic characteristics, together with a knowledge of hepatic P-450 metabolism and common enzyme-inducing and enzyme-inhibiting drugs, can greatly assist physicians in predicting interactions that may be clinically relevant. This article reviews the pharmacology of drug interactions that can occur with hydroxymethylglutaryl - coenzyme A (HMG-CoA) reductase inhibitors (statins) to illustrate the scope of the problem and the ways in which physicians may manage this important therapeutic class of drugs.


Related Articles

  • Interaction between Several Medicines and Statins. Fujino, Hideki; Saito, Tsuyoshi; Tsunenari, Yoshihiko; Kojima, Junji // Drug Research / Arzneimittel-Forschung (Editio Cantor Verlag fur;Mar2003, Vol. 53 Issue 3, p145 

    Describes in vitro experiments using human hepatic microsomes to gain a better understanding of drug-drug interaction between various medicinal substances and statins. Metabolic clearance of atorvastatin; Negligibility of the metabolic inhibition of pitavastatin.

  • AHA: beware of drug interactions with statins, CV therapies.  // Reactions Weekly;10/29/2016, Vol. 1625 Issue 1, p7 

    The article discusses the interactions between statins and other cardiovascular (CV) therapies according to the non-profit organization American Heart Association.

  • Taking a Macrolide With a Statin Raises Risk of Statin Toxicity.  // Nutrition Health Review: The Consumer's Medical Journal;2014, Issue 110, p14 

    The article reports on a study which found that taking a macrolide with a statin increases the risk of statin toxicity.

  • Stereoselective introduction of two chiral centers by a single diketoreductase: an efficient biocatalytic route for the synthesis of statin side chains. Xuri Wu; Lili Wang; Shuzhen Wang; Yijun Chen // Amino Acids;Jun2010, Vol. 39 Issue 1, p305 

    Statins, including atorvastatin (Lipitor®), are the top-selling drugs in the world. The biocatalytic production of chiral side chains of statin drugs is of great interest to academia and industry. Stereoselective double reduction of a β,δ-diketo ester catalyzed by a diketoreductase...

  • Potentially Fatal Interaction between Diltiazem and Statins. Gladding, Patrick; Pilmore, Helen; Edwards, Colin // Annals of Internal Medicine;4/20/2004, Vol. 140 Issue 8, pE-676 

    Discusses the results of a fatal interaction between diltiazem and statins. Description of the interaction between diltiazem and statins, atorvastatin and simvastatin, as the objective; Details of three case reports of patients taking this combination and complications leading to death;...

  • An understanding of the pharmacokinetics of HMG-CoA reductase inhibitors should help reduce the incidence of serious drug interactions.  // Drugs & Therapy Perspectives;Dec2003, Vol. 19 Issue 12, p21 

    Discusses the role of the pharmokinetics of HMG-CoA reductase inhibitors or statins in helping reduce the incidence of serious drug interactions. Function of the inhibitors in cholesterol synthesis; Information on adverse events associated with statins, including skeletal muscle abnormalities;...

  • Rhabdomyolysis due to probable interaction between simvastatin and ritonavir. Cheng, Cindy H.; Miller, Christine; Lowe, Christopher; Pearson, Vincent Earl // American Journal of Health-System Pharmacy;4/15/2002, Vol. 59 Issue 8, p1 

    Discusses the case of rhabdomyolysis that occurred in a woman within several days of ritonavir being added to a drug regimen that included simvastatin. Adverse drug reaction in the case; Increase in the frequency of skeletal muscle toxicities when statins are given with a CYP3A4 inhibitor;...

  • Beware statins with macrolides. Ewing, Iain; White, William // BMJ: British Medical Journal (Overseas & Retired Doctors Edition;5/7/2011, Vol. 342 Issue 7805, p991 

    A letter to the editor in response to the article "Effect of statin treatment on short term mortality after pneumonia episode: cohort study," by L. Douglas, S. Evan, and L. Smeeth in the April 6, 2011 issue of the periodical is presented.

  • Vytorin. Trecroci, Daniel // Diabetes Health;Nov2005, Vol. 14 Issue 11, p18 

    The article evaluates the Vytorin drug which acts as statin and ACE inhibitor to keep cholesterol and blood pressure at healthy levels for people with and without diabetes from Merck/Schering-Plough Pharmaceuticals and provides information on its side effects. INSETS: Vytorin Beats Lipitor in...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics