Frishman William H, Horn John
Department of Medicine, New York Medical College/Westchester Medical Center, Valhalla, New York 10595, USA.
Cardiol Rev. 2008 Jul-Aug;16(4):205-12. doi: 10.1097/CRD.0b013e31817532db.
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.
他汀类药物是研究最为充分的一类药物，他汀类药物在治疗和预防心血管疾病和脑血管疾病方面的益处已有充分记录。他汀类药物单药治疗安全且耐受性良好，不良事件发生率较低。然而，提高他汀类药物血浆浓度的情况，如高剂量或联合治疗，会增加不良事件的潜在风险。科学期刊中对药物相互作用的编目以及我们对药物代谢理解的提高意味着他汀类药物相互作用是一个可避免的问题。然而，仍有大量患者被开具相互作用的药物，并且与他汀类药物治疗相关的严重不良事件中约50% 是由药物相互作用引起的。在他汀类药物类别中，每种药物都有独特的药代动力学特征，这可能使一种他汀类药物比另一种更适合特定的治疗方案或患者群体。在开始对患者进行他汀类药物治疗或在他汀类药物类别中的不同药物之间切换患者之前，应仔细考虑降脂疗效以及药物相互作用的风险情况。
