Prescription of statins and pharmacokinetic interactions in Colombian patients

ABSTRACT

Background: Statins have extensive hepatic metabolism and can have multiple pharmacological interactions. The aim was to identify the main pharmacokinetic interactions between statins and their comedications in a group of patients from Colombia.

Research design and methods: A cross-sectional study of pharmacokinetic interactions in patients treated with statins who were identified from a population database. The interactions were documented using the Lexicomp® database.

Results: A total of 123,026 patients with statin prescriptions were identified, with a mean age of 68.4 ± 11.5 years; 57.1% were women, and 81.6% received atorvastatin. A total of 19.4% (n = 23.831) of patients presented pharmacological interactions. Some 15,474 (12.6%) had interactions classified as category C, 7.4% (n = 9077) as category D, and 0.5% (n = 660) as category X. 36.8% of the patients with lovastatin prescriptions had some interaction. Age older than 65 years, male sex, residence in capital cities, comorbidities, endocrine pathologies and HIV were associated with an increase in the probability of having contraindicated or risky interactions.

Conclusions: Important interactions between statins and other medications were more common in adults over 65 years of age and those with endocrine comorbidities or HIV infection. This knowledge should help when proposing solutions that reduce the risk of adverse reactions.

KEYWORDS:

• Hypolipidemic agents
• hydroxymethylglutaryl-CoA reductase inhibitors
• drug interactions
• pharmacovigilance

Acknowledgments

The authors would like to acknowledge Soffy Claritza López for her work in obtaining the database.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

A reviewer of this paper discloses owning four shares in AstraZeneca PLC and having received honoraria and/or travel reimbursement for events sponsored by AKCEA, Amgen, AMRYT, Link Medical, Mylan, Napp and Sanofi. Peer reviewers on this manuscript have no other relevant financial or other relationships to disclose.

Author contributions

LFVR: conceptualization, methodology, formal analysis, investigation, data curation, writing original draft. DAMM: methodology, formal analysis, investigation. CGG: methodology, formal analysis, investigation. JEMA: methodology, validation, formal analysis, resources, writing, review and editing, supervision.

Availability of data and material

Name of repository: protocols.io

Code availability to repository data set: dx.doi.org/10.17504/protocols.io.bikkkcuw

Ethical approval

The protocol was approved by the Bioethics Committee of the Universidad Tecnológica de Pereira (Technological University of Pereira) Number: 0402-2019.

Additional information

Funding

This paper was not funded.