Veterans Administration Western New York Healthcare System, State University of New York at Buffalo, Buffalo, NY 14215, USA; Department of Pharmacy, State University of New York at Buffalo, Buffalo, NY, USA; Department of Medicine, State University of New York at Buffalo, Buffalo, NY, USA.
Department of Pharmacy Practice, South College School of Pharmacy, Knoxville, TN, USA.
J Clin Lipidol. 2014 May-Jun;8(3 Suppl):S30-46. doi: 10.1016/j.jacl.2014.02.010.
The statins are widely used worldwide to reduce risk for cardiovascular events in both the primary and secondary prevention settings. Although generally quite safe, the statins can be associated with a variety of serious side adverse effects, including myalgia, myopathy, and changes in plasma enzymes of hepatic origin. Although rare, the most serious of these is rhabdomyolysis. Several drugs can interfere with the metabolism and disposal of the statins, thereby increasing risk for adverse events. It is important that clinicians treating patients with statins be aware of the potential for drug-drug interactions between each statin and specific other drugs and take measures to prevent them. The prediction of potential drug-drug interactions derives from basic pharmacokinetic principles. Certain drug interactions are predicted by measuring the effect of interacting drugs on blood plasma concentrations of the statin. Individual patient variations resulting in part from polymorphisms in the metabolizing enzymes confound some of these predictions. Based on these known effects, a new classification for predicting statin drug interactions is proposed. This report discusses likely prescription and nonprescription interactions as well as potential alternatives for special populations.
他汀类药物在全球范围内广泛用于降低一级和二级预防环境中的心血管事件风险。尽管通常非常安全，但他汀类药物可能会引起各种严重的副作用，包括肌肉疼痛、肌病和肝来源的血浆酶变化。虽然罕见，但其中最严重的是横纹肌溶解症。有几种药物可以干扰他汀类药物的代谢和处置，从而增加不良反应的风险。治疗接受他汀类药物治疗的患者的临床医生应意识到每种他汀类药物与特定其他药物之间发生药物-药物相互作用的可能性，并采取措施预防这些相互作用。潜在药物相互作用的预测源于基本的药代动力学原理。某些药物相互作用通过测量相互作用药物对他汀类药物的血浆浓度的影响来预测。部分由代谢酶的多态性引起的个体患者变异使其中一些预测变得复杂。基于这些已知的影响，提出了一种新的他汀类药物相互作用预测分类。本报告讨论了可能的处方和非处方相互作用以及特殊人群的潜在替代药物。
