Interaction potential between clarithromycin and individual statins-A systematic review.

Autor: Hougaard Christensen MM; Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark.; Department of Clinical Research, University of Southern Denmark, Odense, Denmark., Bruun Haastrup M; Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark.; Department of Clinical Research, University of Southern Denmark, Odense, Denmark., Øhlenschlaeger T; Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark., Esbech P; Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark., Arnspang Pedersen S; Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark., Bach Dunvald AC; Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark., Bjerregaard Stage T; Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Odense, Denmark., Pilsgaard Henriksen D; Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark.; Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Odense, Denmark., Thestrup Pedersen AJ; Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark.
Jazyk: angličtina
Zdroj: Basic & clinical pharmacology & toxicology [Basic Clin Pharmacol Toxicol] 2020 Apr; Vol. 126 (4), pp. 307-317. Date of Electronic Publication: 2019 Nov 08.
DOI: 10.1111/bcpt.13343
Abstrakt: The high prevalence of statin and clarithromycin utilization creates potential for overlapping use. The objectives of this MiniReview were to investigate the evidence base for drug-drug interactions between clarithromycin and currently marketed statins and to present management strategies for these drug combinations. We conducted a systematic literature review following PRISMA guidelines with English language studies retrieved from PubMed and EMBASE (from inception through March 2019). We included 29 articles (16 case reports, 5 observational, 5 clinical pharmacokinetic and 3 in vitro studies). Based on mechanistic/clinical studies involving clarithromycin or the related macrolide erythromycin (both strong inhibitors of CYP3A4 and of hepatic statin uptake transporters OATP1B1 and OATP1B3), clarithromycin is expected to substantially increase systemic exposure to simvastatin and lovastatin (>5-fold increase in area under the plasma concentration-time curve (AUC)), moderately increase AUCs of atorvastatin and pitavastatin (2- to 4-fold AUC increase) and slightly increase pravastatin exposure (≈2-fold AUC increase) while having little effect on fluvastatin or rosuvastatin. The 16 cases of statin-clarithromycin adverse drug reactions (rhabdomyolysis (n = 14) or less severe clinical myopathy) involved a CYP3A4-metabolized statin (simvastatin, lovastatin or atorvastatin). In line, a cohort study found concurrent use of clarithromycin and CYP3A4-metabolized statins to be associated with a doubled risk of hospitalization with rhabdomyolysis or other statin-related adverse events as compared with azithromycin-statin co-administration. If clarithromycin is necessary, we recommend (a) avoiding co-administration with simvastatin, lovastatin or atorvastatin; (b) withholding or dose-reducing pitavastatin; (c) continuing pravastatin therapy with caution, limiting pravastatin dose to 40 mg daily; and (d) continuing fluvastatin or rosuvastatin with caution.
(© 2019 Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society).)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje