Clinical conundrums involving statin drug-drug interactions
Section snippets
Specific statin drug-drug interactions
The National Lipid Association Scientific Statement on Statin Intolerance cites statin DDIs as a key modifiable risk factor for preventing statin-associated muscle symptoms.4 The medical literature is replete with many statin DDIs that are well-characterized (e.g. gemfibrozil, calcium channel blockers, azole antifungals) with clear recommendations by the manufacturer, U.S. Food and Drug Administration (FDA), or professional society guidelines on how to address them.6 Recommendations range from
Conclusions
The underlying mechanisms of statin DDIs are multifaceted, and many common medications have an extensive evidence base and consensus opinions that explain these interactions and provide guidance to clinicians. However, there are statin DDIs that are particularly challenging and are less-well-established and may warrant clinical attention. Ritonavir (combined with nirmatrelvir), daptomycin, tacrolimus, and amiodarone are older medications that are known to have different degrees of DDI with
Disclosures
None.
Funding
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Declaration of Competing Interest
None.
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