Barbara S. Wiggins,
Pharm.D., Clinical Cardiology Pharmacy Specialist, Medical University of South
Carolina, Charleston and chair of writing committee of the scientific statement
said, "Healthcare providers and their patients who take statins need to be
aware that these medications could interact with their other heart disease
medications, such as medications to control blood pressure, treat abnormal
heart rhythms, and other"
‘The American Heart Association statement has highlighted few changes for labeling statin drugs to manage potential drug interactions with heart disease drugs.’
"While many of
these drug combinations are safe, every patient is different and will tolerate
medications differently. Patients need to be aware that interactions can occur
and should speak to their healthcare providers about any unusual side effects
or concerns," she said.
Interaction between the
drugs usually occur when two or more medicines are taken together and this
might either enhance or inhibit the effectiveness of one or both the drugs.
It is estimated that
around 2.8 % of cases admitted to the hospitals are due to drug interactions
which may be even higher because most of the patients are admitted for issues
related to adverse drug reactions and side effects or underlying medical
conditions like thyroid or rheumatic disease which may conceal drug
interactions.
The writing committee
highlighted few changes for labeling statins after identifying potential drug
interactions between statins and other heart disease medications.
Heart Disease
Medications with Statins
Some of the heart
disease medications examined by the writing committee for potential drug
interactions with statins include:
- Antiarrhythmic
drugs
- Congestive heart
failure drugs
- Anti-platelet and
anticoagulant drugs
- Immunosuppressive
agents
- Calcium channel
blockers
- Non-statin
cholesterol drugs
Identification of
specific doses of statins with heart disease medications that may be useful for
treatment as well as identifying harmful drug interactions would help the
patients.
How to Minimize the
Risk of Adverse Effects
The statement guidance
for minimizing the risk of adverse effects include:
- Health care
providers to review and identify the medications taken by statin-treated
patients during their hospital visit.
- Possible drug
interactions between statins and heart disease drugs should be identified
and evaluated at an earlier stage.
- Appropriate dose
adjustments can be done to manage potential drug interactions.
- Discontinuing the
interacting medicine or prescribing a safer statin medication for
treatment can minimize the risk of adverse effects.
Use of Statins and
Heart Disease Medications
Statin drugs
like
atorvastatin,
lovastatin,
pravastatin,
rosuvastatin or
simvastatin may be prescribed for the treatment
of atherosclerosis (hardening or narrowing of the arteries due to the plaque
build up inside the arteries).
According to the
American Heart Association statistics,
cardiovascular disease is found to be
a leading cause of death resulting in 17.3 million deaths per year which might
increase more than 23.6 million by 2030.
Heart disease
medications include:
- Antiarrhythmic drugs like amiodarone,
procainamide, mexiletine for treatment of abnormal heart
rhythms,
- Anti-platelet and
anticoagulant drugs like aspirin, warfarin for thinning blood,
- Calcium channel
blockers like amlodipine, nifedipine, felodipine for blood pressure
treatment,
- Non statin
cholesterol drugs for the treatment of high cholesterol levels,
- Congestive heart
failure drugs and immunosuppressive agents for heart transplant patients.
Drug-Drug Interactions
Drug interaction is
usually an interaction between two or more drugs when administered together. They
are broadly classified as
Pharmacodynamic drug
interactions: Drug interactions that occur when the mode of action of one
drug interferes with another.
Pharmacokinetic drug
interactions: This type of drug interaction occurs when properties like
absorption, distribution, metabolism or excretion of one drug interfere with
another drug.
Common Reasons for Drug
Interactions: - Lack of knowledge
among health care providers about potential drug interactions.
- Patient may
consult several health care professionals for treatment and may be
prescribed with multiple drugs which might lead to interaction.
- Several drugs
taken for multiple health issues by elderly patients may also be a reason
for drug interactions.
References :- Drug Development and Drug Interactions - (http://www.fda.gov/Drugs/DevelopmentApprovalProcess/DevelopmentResources/DrugInteractionsLabeling/ucm080499.htm)
- Atherosclerosis - (http://www.heart.org/HEARTORG/Conditions/Cholesterol/WhyCholesterolMatters/Atherosclerosis_UCM_305564_Article.jsp#.WARbKMmSTIU)
- Heart Disease, Stroke and Research Statistics At-a-Glance - (https://www.heart.org/idc/groups/ahamah-public/@wcm/@sop/@smd/documents/downloadable/ucm_480086.pdf)
Source: Medindia