AHA Releases Guidelines on Statins CVD Drug Interactions

Interactions between statins and other cardiovascular medications, which may cause hospitalization, can be avoided if properly understood and managed, according to a new scientific statement from the American Heart Association.

Statins are commonly prescribed for patients with and at risk for cardiovascular disease, and drug-drug interactions that cause hospitalization are common in this population.
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In an effort to guide health care providers in safely administering medications, the American Heart Association created a task force of researchers to construct a scientific statement about these interactions, dose limits, adverse effects, and monitoring parameters.

The scientific statement includes multiple tables that list drugs commonly used with statins, the magnitude of their interaction, and recommended alternative regimens.

For example, the task force recommends limiting the dose of lovastatin to 40 mg daily when taken with amiodarone. When taken in combination with colchicine, multiple statins including atorvastatin and fluvastatin should be closely monitored for muscle-related toxicity.

“A review of all medications that statin-treated patients are taking should be done at each clinical encounter and during transitions of care within a health system so that [drug-drug interactions] can be identified early, evaluated, and managed appropriately by implementing doses adjustments, changing to a safer statin medication, or discontinuing when needed,” the task force concluded.

“A thorough understanding of the pharmacokinetics of statins and other select medications that are often prescribed in combination is paramount in ensuring patient safety.”

—Amanda Balbi

Reference:

Wiggins BS, Saseen JJ, Page II RL, et al; American Heart Association Clinical Pharmacology Committee of the Council on Clinical Cardiology; Council on Hypertension; Council on Quality of Care and Outcomes Research; and Council on Functional Genomics and Translational Biology. Recommendations for management of clinically significant drug-drug interactions with statins and select agents used in patients with cardiovascular disease: a scientific statement from the American Heart Association [published online October 17, 2016]. Circulation. doi:10.1161/CIR.0000000000000456.