Korean J Clin Pharm.  2020 Mar;30(1):31-35. 10.24304/kjcp.2020.30.1.31.

Evaluation of Potential Drug-Drug Interactions in Patients Taking HMG CoA-reductase Inhibitors

• Lee KJ
• Kim KR
• Seong JM
• Ryu SW
• Lee HY
• Cho S
• Cheong Y
• Nam KN
• Lee YJ

• KMID: 2510443
• DOI: http://doi.org/10.24304/kjcp.2020.30.1.31

Abstract

Objective
The 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) are frequently prescribed medications worldwide for the treatment of hypercholesterolemia. Statins are considered to be well tolerated; however, they have a potential for myotoxicity. Concomitant drugs that inhibit cytochrome P450 3A4 can increase the concentration of statins and thus the risk of developing myotoxicity. The purpose of this study was to evaluate risk factors associated with potential drug-drug interactions in patients receiving statins.
Methods
The subjects of this study were patients aged more than 18 years who received at least one prescription of statins in a general hospital located in Chuncheon-si, Korea, between January 1, 2018, and March 31, 2018. Data regarding statin use and baseline characteristics was collected from the computerized hospital database. Logistic regression analysis was used to identify risk factors associated with potential drug-drug interactions.
Results
A total of 1061 patients were finally included in the study. The incidence of potential drug-drug interactions was 45% in all subjects. According to the results of the multivariate logistic regression analysis, myocardial infarction as the indication of statin, arrhythmia or heart failure as a comorbidity, and aspartate aminotransferase levels higher than 40 IU/L were significant risk factors for potential drug-drug interactions in study subjects. Diltiazem was the most commonly co-prescribed drug that caused potential drug-drug interactions with statins.
Conclusion
There was a considerable rate of potential drug-drug interactions in patients receiving statins. Health care professionals should attempt to reduce potential drug-drug interactions during statin administration.

Keyword

Risk factors; HMG CoA-reductase inhibitors; atorvastatin; simvastatin; drug interaction