An updated review of interactions of statins with antibacterial and antifungal agents

Eljaaly, Khalid; Alshehri, Samah

doi:10.15761/jts.1000181

Cited by 7 publications

(5 citation statements)

References 47 publications

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“…Simvastatin is not recommended for co-administration with clarithromycin and erythromycin because of an increase of 11-fold and 4-fold of its AUC, respectively compared with basal values. A similar increase is expected with lovastatin [ 45 – 47 ]. Erythromycin also increased 3-fold the pitavastatin AUC, so the manufacturer recommends not to exceed the dose of 1 mg a day if co-ad-ministered [ 47 ].…”

Section: Macrolidessupporting

confidence: 80%

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Clinically important pharmacokinetic drug-drug interactions with antibacterial agents

Torrent Rodríguez,

Font i Barceló,

Barrantes González

et al. 2024

Rev Esp Quimioter

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Antimicrobial agents are widely used, and drug interactions are challenging due to increased risk of adverse effects or reduced efficacy. Among the interactions, the most important are those affecting metabolism, although those involving drug transporters are becoming increasingly known. To make clinical decisions, it is key to know the intensity of the interaction, as well as its duration and time-dependent recovery after discontinuation of the causative agents. It is not only important to be aware of all patient treatments, but also of supplements and natural medications that may also interact. Although they can have serious consequences, most interactions can be adequately managed with a good understanding of them. Especially in patients with polipharmacy it is compulsory to check them with an electronic clinical decision support database. This article aims to conduct a narrative review focusing on the major clinically significant pharmacokinetic drug-drug interactions that can be seen in patients receiving treatment for bacterial infections.

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Section: Macrolidessupporting

confidence: 80%

“…A similar increase is expected with lovastatin [ 45 – 47 ]. Erythromycin also increased 3-fold the pitavastatin AUC, so the manufacturer recommends not to exceed the dose of 1 mg a day if co-ad-ministered [ 47 ]. As pitavastatin lacksof appreciable CYP3A4 metabolism, this interaction seems mainly due to transporter mediated PK DDI.…”

Section: Macrolidessupporting

confidence: 80%

Clinically important pharmacokinetic drug-drug interactions with antibacterial agents

Torrent Rodríguez,

Font i Barceló,

Barrantes González

et al. 2024

Rev Esp Quimioter

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“…Moreover, concurrent use of those drugs (e.g., cyclosporin, digoxin, ticagrelor, and antifungal) with hydrophilic statin also remarkably increased the conditional probabilities of the outcome in accordance with results of BN. Therefore, these medications induced statin retention leading to higher odds of the outcome corresponding to previous studies [31][32][33][40][41][42][43]. In addition, a patient who had been concurrently taking high-dose lipophilic statins, clarithromycin, and antifungals should be closely monitored about the outcome due to the high odds of outcome.…”

Section: Shap Beeswarm Plot Of Rf Shap Waterfall Plot Of Rf Shap Bees...mentioning

confidence: 88%

Detection of statin-induced rhabdomyolysis and muscular related adverse events through data mining technique

Kunakorntham

Pattanaprateep

Dejthevaporn

et al. 2022

BMC Med Inform Decis Mak

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Background and objective Rhabdomyolysis (RM) is a life-threatening adverse drug reaction in which statins are the one commonly related to RM. The study aimed to explore the association between statin used and RM or other muscular related adverse events. In addition, drug interaction with statins were also assessed. Methods All extracted prescriptions were grouped as lipophilic and hydrophilic statins. RM outcome was identified by electronically screening and later ascertaining by chart review. The study proposed 4 models, i.e., logistic regression (LR), Bayesian network (BN), random forests (RF), and extreme gradient boosting (XGBoost). Features were selected using multiple processes, i.e., bootstrapping, expert opinions, and univariate analysis. Results A total of 939 patients who used statins were identified consisting 15, 9, and 19 per 10,000 persons for overall outcome prevalence, using statin alone, and co-administrations, respectively. Common statins were simvastatin, atorvastatin, and rosuvastatin. The proposed models had high sensitivity, i.e., 0.85, 0.90, 0.95 and 0.95 for LR, BN, RF, and XGBoost, respectively. The area under the receiver operating characteristic was significantly higher in LR than BN, i.e., 0.80 (0.79, 0.81) and 0.73 (0.72, 0.74), but a little lower than the RF [0.817 (95% CI 0.811, 0.824)] and XGBoost [0.819 (95% CI 0.812, 0.825)]. The LR model indicated that a combination of high-dose lipophilic statin, clarithromycin, and antifungals was 16.22 (1.78, 148.23) times higher odds of RM than taking high-dose lipophilic statin alone. Conclusions The study suggested that statin uses may have drug interactions with others including clarithromycin and antifungal drugs in inducing RM. A prospective evaluation of the model should be further assessed with well planned data monitoring. Applying LR in hospital system might be useful in warning drug interaction during prescribing.

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“…Since ITZ increases the AUC values of lovastatin, simvastatin, and atorvastatin by 15-20, 19, and 2.3-3.3 times their original values, respectively, its use with statins is contraindicated. 30 Elderly patients should be given preference for topical therapy, as well as systemic therapy should only be considered in the cases where topical therapy fails, or the condition is extensive or the recalcitrant. 23…”

Section: Expert Opinion On Use Of Itz In Medically Compromised Patientsmentioning

confidence: 99%

Efficacy of super bioavailable itraconazole in the management of dermatophytosis in India

M.,

Hawelia,

Bharadwaj

et al. 2023

Int J Res Dermatol

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Itraconazole (ITZ) is a commonly prescribed oral antifungal agent in India and has a low minimum inhibitory concentration when compared to other oral antifungals. However, clinicians have reported inconsistent clinical responses despite its high skin levels, which may be due to variations in pelletization parameters, which affect its bioavailability and serum levels. Conventional ITZ has a maximum bioavailability of 55%; however, this is unpredictable and inconsistent. In contrast, the novel ITZ formulation, super bioavailable ITZ (ITZ-SB), has targeted drug release in the small intestine, resulting in predictable serum levels with minimal interindividual variability. This makes it a potentially useful drug in treating recalcitrant dermatophytosis. This expert opinion highlights the benefits of novel ITZ-SB with the incorporation of SUBA® technology. The SUBA® technology improves the bioavailability of poorly soluble drugs by ‘solid dispersion’ in polymer to increase drug absorbency. This technology also has potential to reduce variability in absorption and adverse effects. Benefits of this technology include more predictable clinical response and lower drug quantities necessary to achieve therapeutic blood levels, making it a promising treatment option for recalcitrant dermatophytosis. Fixtral SB, which uses this technology, is a novel weapon in the arsenal of treatments for superficial mycoses.

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An updated review of interactions of statins with antibacterial and antifungal agents

Cited by 7 publications

References 47 publications

Clinically important pharmacokinetic drug-drug interactions with antibacterial agents

Clinically important pharmacokinetic drug-drug interactions with antibacterial agents

Detection of statin-induced rhabdomyolysis and muscular related adverse events through data mining technique

Efficacy of super bioavailable itraconazole in the management of dermatophytosis in India

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