Statin-drug interactions: not a class effect.
Statins are one of the most well-studied class of drugs and the benefits of statins in the treatment and prevention of both cardiovascular and cerebrovascular disease are well documented. Statin monotherapy is safe and well tolerated, with a low frequency of adverse events. However, conditions that raise the plasma concentrations of statins, such as high doses or combination therapy, can increase the potential risk of adverse events. The cataloging of drug interactions within scientific journals and improvements in our understanding of drug metabolism mean that statin-drug interactions are an avoidable problem. However, large numbers of patients are still prescribed interacting medications, and approximately 50% of serious adverse events related to statin therapy are due to drug-drug interactions. Within the statin class of drugs, each agent has a unique pharmacokinetic profile that can make one statin more suitable than another for a particular treatment regimen or patient group. Careful consideration of the lipid lowering efficacy and also the risk profile for drug-drug interactions should be taken before initiating patients on statin therapy, or switching patients between different drugs of the statin class.
Frishman
William H
WH
Department of Medicine, New York Medical College/Westchester Medical Center, Valhalla, New York 10595, USA. William_Frishman@nymc.edu
Horn
John
J
D000924:Anticholesteremic Agents / Q000009:adverse effects / Q000493:pharmacokinetics* / Q000627:therapeutic use; D002561:Cerebrovascular Disorders / Q000517:prevention & control; D003327:Coronary Disease / Q000517:prevention & control; D051544:Cytochrome P-450 CYP3A / Q000187:drug effects; D004347:Drug Interactions; D050171:Dyslipidemias / Q000188:drug therapy; D019317:Evidence-Based Medicine; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects / Q000493:pharmacokinetics* / Q000627:therapeutic use; D009135:Muscular Diseases / Q000139:chemically induced; D017410:Practice Guidelines as Topic; D012206:Rhabdomyolysis / Q000139:chemically induced
D000924:Anticholesteremic Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D051544:Cytochrome P-450 CYP3A; C510163:CYP3A4 protein, human