Pharmacokinetic-Pharmacodynamic Drug Interactions with HMG-CoA Reductase Inhibitors

  title={Pharmacokinetic-Pharmacodynamic Drug Interactions with HMG-CoA Reductase Inhibitors},
  author={David Williams and John Feely},
  journal={Clinical Pharmacokinetics},
The HMG-CoA reductase inhibitors (statins) are effective in both the primary and secondary prevention of ischaemic heart disease. As a group, these drugs are well tolerated apart from two uncommon but potentially serious adverse effects: elevation of liver enzymes and skeletal muscle abnormalities, which range from benign myalgias to life-threatening rhabdomyolysis. Adverse effects with statins are frequently associated with drug interactions because of their long-term use in older patients who… Expand
Drug–Drug Interactions Between HMG-CoA Reductase Inhibitors (Statins) and Antiviral Protease Inhibitors
Simvastatin and lovastatin have the highest potency for drug–drug interaction with potent CYP3A inhibitors such as ritonavir- or cobicistat-boosted HIV-PI or the hepatitis C virus, telaprevir or boceprevir, and therefore their coadministration is contraindicated. Expand
Drug–drug interactions that interfere with statin metabolism
The pharmacokinetic aspects of the drug–drug interaction with statins and genetic polymorphisms in CYPs, which are involved in the metabolism of statins, are discussed and the importance of establishing a system utilizing electronic medical information practically to avoid adverse drug reactions is highlighted. Expand
Genetic Polymorphisms in Cytochrome P450 Enzymes
  • A. Vermes, I. Vermes
  • Medicine
  • American journal of cardiovascular drugs : drugs, devices, and other interventions
  • 2004
Genotyping may help to select the appropriate HMG-CoA reductase inhibitor and the optimal dosage during the start of the treatment and will allow for more efficient individual therapy. Expand
An updated review of pharmacokinetic drug interactions and pharmacogenetics of statins
The establishment of biomarkers based on novel mechanisms, such as the leakage of microRNAs into the peripheral blood associated with the muscle toxicity, is important for the early detection of statin side effects. Expand
Statins and their interactions with other lipid-modifying medications: safety issues in the elderly
The major adverse events associated with statin use, with particular reference to the elderly patient, are summarized, including factors which might increase the risk of adverse effects. Expand
Role of P‐glycoprotein in Statin Drug Interactions
Drug interaction studies involving statins and digoxin support a role for P‐gp, an efflux protein located in the gastrointestinal tract, placenta, kidneys, brain, and liver, and many additional drugs such as diltiazem, verapamil, itraconazoles, ketoconazole, and cyclosporine, interact with statin and are modulators of both CYP3A4 and P‐ gp. Expand
Lipid lowering inefficacy of high-dose statin therapy due to concurrent use of phenytoin.
A case of a patient on multiple lipid-lowering medications, including high-dose atorvastatin whose LDL cholesterol improved significantly after discontinuation of phenytoin is presented, and a review of the literature for similar cases is discussed. Expand
Drug interactions with statins
Possible adverse effects of statins can occur due to interactions in concomitant use of drugs that substantially inhibit or induce their methabolic pathway. Expand
Lipid-lowering therapies and liver enzymes
Lipid-lowering drugs, especially HMGCoA reductase inhibitors, are widely used in the treatment and prevention of cardiovascular disease. They are generally well tolerated. The main, but uncommon,Expand
Cytochrome P450-mediated cardiovascular drug interactions
  • A. Scheen
  • Medicine
  • Expert opinion on drug metabolism & toxicology
  • 2011
Clinicians are encouraged to develop their knowledge of CYP-mediated DDIs so that they can choose safe drug combination regimens, adjust drug dosages appropriately and conduct therapeutic drug monitoring for drugs with narrow therapeutic indices. Expand