Comparative Analysis of Clinical and Non-Clinical Pharmacokinetic Interactions of Statins with Other Drugs
Mitsuo Saito, Mutsuko Hirata, Tsutomu Urano, Shinji Miyake, Ryuichi Hasegawa · Iryo Yakugaku (Japanese Journal of Pharmaceutical Health Care and Sciences) · 2007
Information on the pharmacokinetic interactions of 8 statins (atorvastatin, simvastatin, lovastatin, fluvastatin, pravastatin, rosuvastatin, pitavastatin and cerivastatin (already withdrawn from the market)) with other drugs such as itraconazole, erythromycin, HIV protease inhibitors, digoxin and cyclosporine, and food products such as grapefruit juice was collected from the literature, summarized and analyzed. The results of clinical drug interaction(s) were then discussed on the basis of nonclinical interaction information regarding hepatic or intestinal metabolism by cytochrome P 450 and drug transporters such as MDR 1 and OATP 2.In conclusion, due to several complicating factors such as plasma protein binding, first pass effect, lipophilicity/hydrophilicity, and inter-conversion between acid and lactone forms, further clinical pharmacokinetic interaction studies will be needed to predict the likelihood of drug interactions.