Drug-drug interactions between vitamin K antagonists and statins: a systematic review

Abstract

Bent S. Lind 1,3 (ORCID 0000-0003-3866-3128) Tore Bjerregaard Stage 4 (ORCID 0000-0002-4698-4389) Maja Hellfritzsch 4,5 (ORCID 0000-0002-9566-420X) Anton Pottegård 4 (ORCID 0000-0001-9314-5679)

MecDDI: Clarified Drug–Drug Interaction Mechanism Facilitating Rational Drug Use and Potential Drug–Drug Interaction Prediction

“…Drugs are frequently reported to be able to interact with multiple co-administered agents. − Particularly, with the rapidly accumulating number of aging people, there is a significant increase in the incidence of multiple acute/chronic diseases, which greatly promotes the administration of combinatorial therapies and a subsequent threat of DDIs. − Therefore, a comprehensive collection of all drugs that interact with the studied drugs is of great importance to the prevention of potential DDIs, and such full lists of DDIs for each drug were provided in MecDDI. In Figure , the drug page that describes the general information of a drug together with the list of DDIs for this drug is provided.…”

Rhabdomyolysis due to warfarin and atorvastatin combination therapy in a patient with ischemic heart disease: (A drug interaction)

“…Combination therapy with these two medications, on the other hand, may result in an increase in INR after 4 weeks or bleeding through the same mechanism. As a result, INR monitoring is suggested [ 15 ].…”

“…Statins are the most commonly used medications in the treatment of cardiovascular underlying disease, either as monotherapy or in combination with other drugs such as warfarin as vitamin K antagonists (VKA). Warfarin is a routinely administered anticoagulant for thromboembolic therapy; nevertheless, due to its narrow therapeutic index, individual dosage responses, and drug interactions, it is sensitive to dose change [ 15 , 16 ]. Statins and warfarin have similar metabolic patterns, with both being metabolized by cytochrome P450 (CYP) enzymes in the liver, mainly CYP2C9 and CYP3A4 [ 15 , 17 ].…”

“…Warfarin is a routinely administered anticoagulant for thromboembolic therapy; nevertheless, due to its narrow therapeutic index, individual dosage responses, and drug interactions, it is sensitive to dose change [ 15 , 16 ]. Statins and warfarin have similar metabolic patterns, with both being metabolized by cytochrome P450 (CYP) enzymes in the liver, mainly CYP2C9 and CYP3A4 [ 15 , 17 ].…”