Statins (cont.)

Pharmacy Author:
Medical and Pharmacy Editor:

Lovastatin and simvastatin should not be combined with erythromycin, ketoconazole, itraconazole, clarithromycin , telithromycin, cyclosporine, boceprevir, telaprevir, voriconazole, danazol (Danocrine), or protease inhibitors. Amiodarone (Cordarone), amlodipine (Norvasc), and ranolazine (Ranexa) also interact with simvastatin and lovastatin.

Another important drug interaction occurs between statins and niacin and fibric acids (for example, gemfibrozil [Lopid], clofibrate [Atromid-S], and fenofibrate [Tricor]). Niacin and the fibric acid drugs can cause rhabdomyolysis or liver failure when used alone, and combining them with statins increases the likelihood of rhabdomyolysis or liver failure. Gemfibrozil should not be combined with statins. Other fibric acids and niacin are used, with caution, in combination with statins.

Cholestyramine (Questran) as well as colestipol (Colestid) bind statins in the intestine and reduce their absorption into the body. To prevent this binding within the intestine, statins should be taken one hour before or four hours after cholestyramine or colestipol.

Stains increase the effect of warfarin (Coumadin). Patients taking statins and warfarin should their blood clotting ability monitored carefully.

What are some examples of Statins?

Statins that are approved for use in the U.S. include:

  • atorvastatin (Lipitor),
  • fluvastatin (Lescol),
  • lovastatin (Mevacor),
  • pravastatin (Pravachol),
  • rosuvastatin (Crestor),
  • simvastatin (Zocor), and
  • pitavastatin (Livalo).

Reference: FDA Prescribing Information

Last Editorial Review: 5/22/2012

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