Background/aim: Cardiovascular diseases usually involve multiple drug co-administration giving the potential for many drug-drug interactions. Limited data is available regarding drug interactions of cardiovascular diseases in Egypt. This work studied potential drug-drug interactions of cardiovascular diseases in Egyptian patients with consideration to incidence, types, management, and prevention. Methods: A cross-sectional retrospective study was performed on outpatients with cardiovascular disorders in the Delta region of Egypt. About 4,100 prescriptions were analyzed for drug-drug interactions. Lexi-comp program was used as the screening tool. Results: The frequency of potential drug-drug interactions was 11% of which cardiovascular drugs represent 3 %. Major therapeutic classes of drug interactions with the cardiovascular drugs were analgesics, antiplatelets, anticoagulants, proton pump inhibitors, anti-gout, and Ginkgo herb. The risk for category X drug interaction requiring avoiding combinations was 39% and the risk for category D drug interaction requiring modifying drug was 61%. The main mechanisms for drug interaction were pharmacokinetics "metabolic inhibitions and P-gp inhibition" and pharmacodynamics interaction and the major reported toxicity was bleeding, nephrotoxicity, irregular heartbeats, visual disturbance, and myopathy. Conclusions: Preventive programs are required for the increased incidence of potential cardiovascular drug interaction in Egypt. Drug monitoring, minimizing risk factors, and increasing awareness of potential drug interaction in cardiovascular diseases are recommended in clinical practice in Egypt.
Background Coadministration of statins and direct acting antiviral agents is frequently used. This study explored the effects of both atorvastatin and lovastatin on pharmacokinetics of a fixed-dose combination of sofosbuvir/ledipasvir “FDCSL”. Methods 12 healthy volunteers participated in a randomized, three-phase crossover trial and were administered a single atorvastatin dose 80 mg plus tablet containing 400/90 mg FDCSL, a single lovastatin dose 40 mg plus tablet containing 400/90 mg FDCSL, or tablets containing 400/90 mg FDCSL alone. Liquid chromatography-tandem mass spectrometry was used to analyze plasma samples of sofosbuvir, ledipasvir and sofosbuvir metabolite “GS-331007” and their pharmacokinetic parameters were determined. Results Atorvastatin caused a significant rise in sofosbuvir bioavailability as explained by increasing in AUC0−∞ and Cmax by 34.36% and 11.97%, respectively. In addition, AUC0-∞ and Cmax of GS-331007 were increased by 73.73% and 67.86%, respectively after atorvastatin intake. Similarly, co-administration of lovastatin with FDCSL increased the bioavailability of sofosbuvir, its metabolite (AUC0-∞ increase by 17.2%, 17.38%, respectively, and Cmax increase by 12.03%, 22.24%, respectively). However, neither atorvastatin nor lovastatin showed a change in ledipasvir bioavailability. Hepatic elimination was not affected after statin intake with FDCSL. Compared to lovastatin, atorvastatin showed significant increase in AUC0-∞ and Cmax of both sofosbuvir and its metabolite. Conclusions Both atorvastatin and lovastatin increased AUC of sofosbuvir and its metabolite after concurrent administration with FDCSL. Statins’ P-glycoprotein inhibition is the attributed mechanism of interaction. The increase in sofosbuvir bioavailability was more pronounced after atorvastatin intake. Close monitoring is needed after co-administration of atorvastatin and FDCSL.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.