Singapore Med J 2013; 54(3): 131-135; http://dx.doi.org/doi:10.11622/smedj.2013044
Cytochrome P450 drug interactions with statin therapy
Goh XW, How CH, Tavintharan S
Correspondence: Dr Ivanna Goh Xin Wei, ivanna.goh@mohh.com.sg
ABSTRACT
Statins are commonly used in the treatment of hyperlipidaemia. Although the benefits of statins are well-documented, they have the potential to cause myopathy and rhabdomyolysis due to the complex interactions of drugs, comorbidities and genetics. The cytochrome P450 family consists of major enzymes involved in drug metabolism and bioactivation. This article aims to highlight drug interactions involving statins, as well as provide updated recommendations and approaches regarding the safe and appropriate use of statins in the primary care setting.
Keywords: colchicine, fibrates, genetic variants, rhabdomyolysis, safety
Singapore Med J 2013; 54(3): 131-135; doi:10.11622/smedj.2013044
REFERENCES
1. Pasternak RC, Smith SC Jr, Bairey-Merz CN, et al. ACC/AHA/NHLBI clinical advisory on the use and safety of statins. J Am Coll Cardiol 2002; 40:567-72.
http://dx.doi.org/10.1016/S0735-1097(02)02030-2 |
| |
2. Hsu WC, Chen WH, Chang MT, Chiu HC. Colchicine-induced acute myopathy in a patient with concomitant use of simvastatin. Clin Neuropharmacol 2002; 25:266-8.
http://dx.doi.org/10.1097/00002826-200209000-00008 |
| |
3. Bellosta S, Paoletti R, Corsini A. Safety of statins: focus on clinical pharmacokinetics and drug interactions. Circulation 2004; 109 (23 Suppl 1):III50-7. Review.
http://dx.doi.org/10.1161/01.CIR.0000131519.15067.1f |
| |
4. Neuvonen PJ, Niemi M, Backman JT. Drug interactions with lipid-lowering drugs: mechanisms and clinical relevance. Clin Pharmacol Ther 2006; 80:565-81.
http://dx.doi.org/10.1016/j.clpt.2006.09.003 |
| |
5. Sahin G, Korkmaz C, Yalcin AU. Which statin should be used together with colchicine? Clinical experience in three patients with nephrotic syndrome due to AA type amyloidosis. Rheumatol Int 2008; 28:289-91.
http://dx.doi.org/10.1007/s00296-007-0435-1 |
| |
6. SEARCH Collaborative Group, Link E, Parish S, et al. SLCO1B1 variants and statin-induced myopathy – a genomewide study. N Engl J Med 2008; 359:789-99.
http://dx.doi.org/10.1056/NEJMoa0801936 |
| |
7. Study of the Effectiveness of Additional Reductions in Cholesterol and Homocysteine (SEARCH) Collaborative Group, Armitage J, Bowman L, et al. Intensive lowering of LDL cholesterol with 80 mg versus 20 mg simvastatin daily in 12,064 survivors of myocardial infarction: a double-blind randomised trial. Lancet 2010; 376:1658-69.
http://dx.doi.org/10.1016/S0140-6736(10)60310-8 |
| |
8. Eckel R. Approach to the patient who is intolerant of statin therapy. J Clin Endocrinol Metab 2010; 95:2015-22.
http://dx.doi.org/10.1210/jc.2009-2689 |
| |
