Statin Toxicity From Macrolide Antibiotic Coprescription

Abstract

Academic Medical Organization of Southwestern Ontario.

Acute kidney disease and renal recovery: consensus report of the Acute Disease Quality Initiative (ADQI) 16 Workgroup

“…In the non-ICU setting, escalating the burden of nephrotoxic medications from two to three medications more than doubles the risk of developing AKI, and 25% of non-critically ill patients who receive three or more nephrotoxins develop AKI 88,144 . Pharmacokinetic drug interactions arising from the administration of some macrolide antibiotics (such as clarithromycin or erythromycin) together with a 3-hydroxy-3-methylglutaryl-coenzyme-A (HMG-CoA) reductase inhibitor (statin) result in a greater number of hospitalizations for AKI from rhabdomyolysis, than those arising from administration of azithromycin (a macrolide that does not powerfully inhibit cytochrome p450 enzyme CYP 3A4 and therefore impair statin clearance) 145 .…”

Macrolide antibiotics and the risk of ventricular arrhythmia in older adults

“…Previous studies have used these databases to study adverse drug events and health outcomes. [22][23][24][25][26][27][28][29][30] With the exception of prescriber specialty (missing in 19% of prescriptions), the databases were complete for all variables used in this study.…”

Risk of adverse events among older adults following co-prescription of clarithromycin and statins not metabolized by cytochrome P450 3A4

“…All of the data were linked anonymously with the use of encrypted health card numbers, a method that has been used previously for studies on adverse drug events, health outcomes and health services. [24][25][26][27][28][29] All variables used in this study were complete except for neighbourhood income (missing for 0.25% of patients) and prescriber specialty (missing for 13.21%). We used the International Classification of Diseases, 9th revision (ICD-9) codes before April 2002 and ICD-10 codes after Apr.…”