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. 2003 Mar 15;31(4):222-6.
doi: 10.1016/s0212-6567(03)79163-x.

[Pharmacological interactions of statins]

[Article in Spanish]
J M Alvarez Gutiérrez  1 , J D López-Torres Hidalgo, P Galdón Blesa, E M García Ruiz, F Naharro de Mora
Affiliations

[Pharmacological interactions of statins]

[Article in Spanish]
J M Alvarez Gutiérrez et al. Aten Primaria. .

Abstract
in English, Spanish

Objective: To determine in primary care the frequency of pharmacological interactions of statins.

Design: Transversal observational study.Setting. Urban health centre.Participants. 384 patients taking statins who were chosen by systematic sampling based on long-treatment cards (95% CI, accuracy 5% and expected proportion of possible interactions unknown).

Main measurements: Consumption of statins, the accompanying medication taken, presence of interactions according to the technical details of statins (Spanish Medication Agency, Ministry of Health and Consumption) and social and demographic variables.

Results: In 55 patients (14.3%) (95% CI, 10.8%-17.8%) one of the statin interactions with the other drugs was checked, especially with acenocoumarol, digoxin and anti-acid drugs. In patients with some interaction, the mean number of other drugs was significantly higher (4.51.5 vs 3.31.9 SD; P<.001). 19.1% of men and 10.8% of women showed interactions, the difference being statistically significant (P=.02). By means of logistic regression, both masculine gender (OR=1.8) and taking of other medication in quantities of 5 or more (OR=2.7) appeared as variables associated with the presence of interactions.

Conclusions: The potential pharmacological interactions of statins reach 14.3% of patients with hypercholesterolaemia who take medication long-term. The possibility of reaching high plasma concentrations of statins and/or of modifying the therapeutic effect of various drugs enables a more appropriate use of statins to be recommended, with prescription of those statins that metabolise less through the P450 cytochrome.

Objetivo: Determinar en el ámbito de atención primaria la frecuencia de potenciales interacciones farmacológicas de las estatinas.

Diseño: Estudio observacional transversal.

Emplazamiento: Centro de salud de características urbanas.

Participantes: Se seleccionó a 384 pacientes consumidores de estatinas mediante muestreo sistemático a partir de las cartillas de largo tratamiento (nivel de confianza del 95%, precisión del ± 5% y proporción esperada de posibles interacciones desconocida).

Mediciones principales: Consumo de estatinas, medicación concomitante, presencia de interacciones según las fichas técnicas de las estatinas (Agencia Española del Medicamento. Ministerio de Sanidad y Consumo) y variables sociodemográficas. Resultados. En 55 pacientes (14,3%; IC del 95%, 10,8–17,8%) se comprobó alguna de las interacciones de las estatinas con el resto de los fármacos, sobre todo con acenocumarol, digoxina y antiácidos. Entre los pacientes con alguna interacción, el número medio de otros medicamentos fue significativamente superior (DE, 4,5 ± 1,5 frente a 3,3 ± 1,9; p < 0,001). Presentaron interacciones el 19,1% de los varones y el 10,8% de las mujeres, resultando la diferencia estadísticamente significativa (p = 0,02). Mediante regresión logística, tanto el sexo masculino (OR= 1,8) como el consumo de otros medicamentos en número de 5 o más (OR = 2,7) aparecieron como variables asociadas a la presencia de interacciones. Conclusiones. Las potenciales interacciones farmacológicas de las estatinas alcanzan al 14,3% de los pacientes con hipercolesterolemia que consumen medicación de forma crónica. La posibilidad de alcanzar concentraciones plasmáticas elevadas de estatinas o de modificar el efecto terapéutico de diversos fármacos permite aconsejar un uso más apropiado de aquéllas, prescribiendo las que utilizan en menor medida el citocromo P-450 para su metabolismo.

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Comment in

  • [Interactions or potentially dangerous associations?].
    Morales Olivas FJ, Estañ Yago L. Morales Olivas FJ, et al. Aten Primaria. 2003 Oct 15;32(6):393-4; author reply 394. doi: 10.1016/s0212-6567(03)79306-8. Aten Primaria. 2003. PMID: 14572409 Free PMC article. Spanish. No abstract available.

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  • [Authors reply].
    Alvarez Gutiérrez JM, López-Torres Hidalgo JD, García Ruiz EM, Naharro De Mora F, Galdón Blesa P. Alvarez Gutiérrez JM, et al. Aten Primaria. 2003;32(4):258-9. doi: 10.1016/s0212-6567(03)79265-8. Aten Primaria. 2003. PMID: 12975094 Free PMC article. Spanish. No abstract available.
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    Barrera Linares E, Ferrer García-Borrás JM. Barrera Linares E, et al. Aten Primaria. 2003;32(4):258. doi: 10.1016/s0212-6567(03)79264-6. Aten Primaria. 2003. PMID: 12975095 Free PMC article. Spanish. No abstract available.
  • [Interactions or potentially dangerous associations?].
    Morales Olivas FJ, Estañ Yago L. Morales Olivas FJ, et al. Aten Primaria. 2003 Oct 15;32(6):393-4; author reply 394. doi: 10.1016/s0212-6567(03)79306-8. Aten Primaria. 2003. PMID: 14572409 Free PMC article. Spanish. No abstract available.

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