Investigation of the co-administration of simvastatin or atorvastatin with cytochrome P4503A4 inhibitors or inducers in cardiology ward

ZHONG Xue; ZHANG Ya-tong; JI Li-wei; HU Xin; CHENG Gang

doi:10.3969/j.issn.1672-8157.2013.04.002

Abstract：Objective: To investigate the co-administration of simvastatin or atorvastatin with cytochrome P4503A4 (CYP3A4) inhibitors or inducers in clinical treatment. Methods: Fifty cases exposed to the co-administration of simvastatin or atorvastatin with CYP3A4 inhibitors or inducers were selected respectively at random in 2012 in cardiology ward of Beijing Hospital. The basic characteristics, clinical treatment information and laboratory indicators of patients were investigated. The average or proportion of relevant indicators of patients were calculated by SPSS18.0 software. Results:There were 100 patients included in the study. Sixty-six percent of the patients were prescribed simvastatin or atorvastatin with CYP3A4 inhibitors, among which the patients used simvastatin accounted for 30%and atorvastatin accounted for 36%. The average duration of concomitant medication use were (7.04 ± 0.29) days. The CYP3A4 inhibitors that usually combined with simvastatin or atorvastatin were amlodipine, diltiazem, ranitidine, amiodarone, and ginkgo;while the CYP3A4 inducers were carbamazepine, prednisolone acetate tablets. The combination of simvastatin or atorvastatin with CYP3A4 inhibitors was more frequently than that with CYP3A4 inducers. There was no significant difference (P>0.05) when comparing the biochemical indicators of patients who used statins combined with inhibitors or not. Conclusion:The co-prescription of simvastatin or atorvastatin with CYP3A4 inhibitors is common in the hospital. Strategies should be taken to avoid co-administration of simvastatin or atorvastatin with CYP3A4 inhibitors or inducers. If it must be used, drug dosage should be limited according to the direction of drug. We should pay attention to the drug interactions with potential adverse effects, and follow-up patients' condition at regular intervals.