Editorial

Drug-drug Interactions and Statin Therapy

Authors: Gianluca Trifiro, MD

Abstract

Drug-drug interactions (DDIs) among widely and chronically prescribed medications are a relevant health issue in clinical practice. Reported incidences in outpatients range from 9.2% to 70.3% for drug interactions of any severity and from 1.2% to 23.3% for those considered of major relevance.1–3 Due to the progressive population ageing in Western Countries, concern has been raised about risks of clinically relevant DDI, as a result of polytherapy. Indeed, elderly patients may have multiple disease states and, therefore, may require a variety of different drugs. According to a recent study,4 the elderly population uses on average 7.0 drugs per person. In addition to polypharmacy, other factors such as age-related physiologic changes, concomitant diseases, genetic constitution and diet may alter drug response, thus predisposing patients to adverse effects and drug interactions.5

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References

1. Bergendal L, Friberg A, Schaffrath A. Potential drug–drug interactions in 5,125 mostly elderly out-patients in Gothenburg, Sweden. Pharm World Sci 1995;17:152–157.
 
2. Rosholm JU, Bjerrum L, Hallas J, et al. Polypharmacy and the risk of drug-drug interactions among Danish elderly. A prescription database study. Dan Med Bull 1998;45:210–213.
 
3. Bjerrum L, Andersen M, Petersen G, et al. Exposure to potential drug interactions in primary health care. Scand J Prim Health Care 2003;21:153–158.
 
4. Bjorkman IK, Fastbom J, Schmidt IK, Bernsten CB, Pharmaceutical Care of the Elderly in Europe Research (PEER) Group. Drug-drug interactions in the elderly. Ann Pharmacother 2002;36:1675–1681.
 
5. Spina E, Scordo MG. Clinically significant drug interactions with antidepressants in the elderly. Drugs Aging 2002;19:299–320.
 
6. Egger SS, Drewe J, Schlienger RG. Potential drug-drug interactions in the medication of medical patients at hospital discharge. Eur J Clin Pharmacol 2003;58:773–778.
 
7. Raschetti R, Morgutti M, Menniti-Ippolito F, et al. Suspected adverse drug events requiring emergency department visits or hospital admissions. Eur J Clin Pharmacol 1999;54:959–963.
 
8. Jankel CA, Fitterman LK. Epidemiology of drug-drug interactions as a cause of hospital admissions.Drug Saf 1993;9:51–59.
 
9. Bergk V, Gasse C, Rothenbacher D, et al. Drug interactions in primary care: impact of a new algorithm on risk determination. Clin Pharmacol Ther 2004;76:85–96.
 
10. Corsini A, Bellosta S, Baetta R, et al. New insights into the pharmacodynamic and pharmacokinetic properties of statins. Pharmacol Ther 1999;84:413–428.
 
11. Piacentini N, Trifiro G, Tari M, et al, UVEC group. Statin-macrolide interaction risk: a population-based study throughout a general practice database. Eur J Clin Pharmacol 2005;61:615–620.
 
12. Ratz Bravo AE, Tchambaz L, Krahenbuhl-Melcher A, et al. Prevalence of potentially severe drug-drug interactions in ambulatory patients with dyslipidaemia receiving HMG-CoA reductase inhibitor therapy. Drug Saf 2005;28:263–275.
 
13. Khandwala HM. Lipid lowering inefficacy of high-dose statin therapy due to concurrent use of phenytoin South Med J 2006;99:1385–1387.