Effects of Vitamin D Supplementation in Atorvastatin‐Treated Patients: A New Drug Interaction With an Unexpected Consequence

  title={Effects of Vitamin D Supplementation in Atorvastatin‐Treated Patients: A New Drug Interaction With an Unexpected Consequence},
  author={Janice B. Schwartz},
  journal={Clinical Pharmacology \& Therapeutics},
  • J. Schwartz
  • Published 1 February 2009
  • Medicine
  • Clinical Pharmacology & Therapeutics
The objective of this study was to determine vitamin D supplementation effects on concentrations of atorvastatin and cholesterol in patients. Sixteen patients (8 men, 8 women; 10 Caucasians, 4 African Americans, 1 Hispanic, 1 Asian), aged 63 ± 11 years (mean ± SD, weight 92 ± 31 kg) on atorvastatin (45 ± 33 mg/day) were studied with and without supplemental vitamin D (800 IU/day for 6 weeks). Levels of vitamin D (1,25‐dihydroxy(OH) and 25 OH‐metabolites), atorvastatin (parent, OH‐acid… 

Effect of vitamin D on bioavailability and lipid lowering efficacy of simvastatin

A significant decrease in the level of cholesterol and triglyceride was showed in ST alone treated group, whereas VD alone failed to alter the blood lipid levels, suggesting that ST alone or in combination with VD does not produce any hepatotoxicity.

Vitamin D Levels and Lipid Response to Atorvastatin

It is suggested that vitamin D concentrations >30 nmol/L may be required for atorvastatin to reduce lipid levels in patients with acute myocardial infarction.

Effect of vitamin D3 supplementation on the pharmacokinetics of digoxin – a pilot study

Results suggest that vitamin D3 supplementation (1000 IU per day) in human volunteers does not produce a P‐gp‐mediated drug interaction with orally administered digoxin.

Vitamin D3 effects on lipids differ in statin and non-statin-treated humans: superiority of free 25-OH D levels in detecting relationships.

Vitamin D lipid-lowering effects appear limited to statin-treated patients and are likely due to decreased cholesterol absorption, suggesting the superiority of determining free 25-OH D levels compared to total 25- OH vitamin D levels when analyzing biologic responses.

No Impact of Vitamin D on the CYP3A Biomarker 4β-Hydroxycholesterol in Patients with Abnormal Glucose Regulation

Evidence is provided that vitamin D3 may not substantially affect hepatic CYP3A4 and the possibility of an impact of intestinal first-pass metabolism of orally administered drugs which should be investigated.

Baseline Vitamin D Deficiency Decreases the Effectiveness of Statins in HIV-Infected Adults on Antiretroviral Therapy

Although 25(OH)D did not change with rosuvastatin, baseline vitamin D deficiency decreased the effectiveness of rosuVastatin and vitamin D supplementation may be warranted for deficient patients initiating statin therapy.

Serum Levels of 25-Hydroxyvitamin D and the CYP3A Biomarker 4β-Hydroxycholesterol in a High-Dose Vitamin D Supplementation Study

A moderate, but statistically significant, negative correlation between CRP and 4β-hydroxycholesterol levels was observed, which supports earlier experimental results that inflammation may suppress hepatic CYP3A activity, a finding of potentially high clinical relevance that warrants further exploration.

Influence of vitamin D supplementation on plasma lipid profiles: A meta-analysis of randomized controlled trials

The lipid modulating effects of vitamin D supplementation should be further investigated though large-scale, randomized trials with adequate doses which can effectively elevated the active form ofitamin D in plasma and with proper population which has hyperlipemia as an inclusion criterion.

Vitamin D Deficiency Impacts Exposure and Response of Pravastatin in Male Rats by Altering Hepatic OATPs

VD deficiency can decrease the response of pravastatin in rats by reducing the liver pravastsatin exposure and expression of hepatic OATPs, consistent with the extended hepatic clearance model theory.



Vitamin D supplementation and total mortality: a meta-analysis of randomized controlled trials.

BACKGROUND Ecological and observational studies suggest that low vitamin D status could be associated with higher mortality from life-threatening conditions including cancer, cardiovascular disease,

Vitamin D Deficiency and Risk of Cardiovascular Disease

Vitamin D deficiency is associated with incident cardiovascular disease and further clinical and experimental studies may be warranted to determine whether correction of vitamin D deficiency could contribute to the prevention of cardiovascular disease.

Pharmacokinetic properties of zolpidem in elderly and young adults: possible modulation by testosterone in men.

The clinical and in vitro data suggest that reduced free serum testosterone may have a modulatory role in age-dependent changes in zolpidem pharmacokinetics in men and recommendations of lower clinical doses of zolPidem in the elderly are consistent with recommendations.

Clinical Pharmacokinetics of Atorvastatin

Atorvastatin is subject to metabolism by CYP3A4 and cellular membrane transport by OATP C and P-glycoprotein, and drug-drug interactions with potent inhibitors of these systems, such as itraconazole, nelfinavir, ritonavir, cyclosporin, fibrates and grapefruit juice, have been demonstrated.

Aging effects on stereoselective pharmacokinetics and pharmacodynamics of verapamil.

Pharmacokinetics and pharmacodynamics were studied after separate single 15-min infusions of each of verapamil's enantiomers in 16 healthy non-smoking subjects ranging in age from 24 to 40 (young) and from 63 to 83 years (elderly).

Transcriptional control of intestinal cytochrome P-4503A by 1alpha,25-dihydroxy vitamin D3.

The hypothesis that 1,25-D3 and VDR induce expression of intestinal CYP3A by binding of the activated VDR-RXR heterodimer to the CYP 3A PXR response element and promoting gene transcription is supported.