A clinician's guide to statin drug-drug interactions

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Presentation transcript:

A clinician's guide to statin drug-drug interactions Kenneth A. Kellick, PharmD, FNLA, Michael Bottorff, PharmD, FNLA, Peter P. Toth, MD, PhD, FNLA Journal of Clinical Lipidology Volume 8, Issue 3, Pages S30-S46 (May 2014) DOI: 10.1016/j.jacl.2014.02.010 Copyright © 2014 Terms and Conditions

Figure 1 Chemical structures of statins. Type I naphthalene statins (lovastatin, pravastatin, simvastatin); type II non-naphthalene (atorvastatin, pitavastatin, rosuvastatin, fluvastatin). Lovastatin and simvastatin are prodrugs. Journal of Clinical Lipidology 2014 8, S30-S46DOI: (10.1016/j.jacl.2014.02.010) Copyright © 2014 Terms and Conditions

Figure 2 Metabolic fate of statins. BCRP, breast cancer–resistant protein, encoded by gene ABCG2; MDR1, multidrug-resistant protein 1; MRP2, multidrug-resistant–associated protein 2, encoded by gene ABCC2; OATP1B1, organic anion transporter protein 1B1, formerly known as OATP2, encoded by SLCO1B1 gene; OATP1B3, organic anion transporter protein 1B3, encoded by the SLCO1B3 gene; P-glycoprotein, P-gp, encoded by the ABCB1 gene. Adapted from Niemi et al.2 Journal of Clinical Lipidology 2014 8, S30-S46DOI: (10.1016/j.jacl.2014.02.010) Copyright © 2014 Terms and Conditions

Figure 3 A proposed ranking of significance with respect to area under the curve (AUC) changes and drug-drug interaction possibilities. AUC, area under the curve; CYP, cytochrome P450. Adapted from Rodrigues et al.17 Journal of Clinical Lipidology 2014 8, S30-S46DOI: (10.1016/j.jacl.2014.02.010) Copyright © 2014 Terms and Conditions