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• W2963758154 endingPage "936" @default.
• W2963758154 startingPage "921" @default.
• W2963758154 abstract "The objectives of this article were to review the mechanism and clinical significance of statins-macrolides interaction, determine which combination has the highest risk for the interaction, and identify key patients' risk factors for the interaction in relation to the development of muscle toxicity. A literature review was conducted in PubMed and Embase (1946 to December 2018) using combined terms: statins - as group and individual agents, macrolides - as group and individual agents, drug interaction, muscle toxicity, rhabdomyolysis, CYP3A4 inhibitors, and OAT1B inhibitors, with forward and backward citation tracking. Relevant English language in vivo studies in healthy volunteers, case reports, and population studies were included. The interaction between statins and macrolides depends on the type of statin and macrolide used. The mechanism of the interaction is due to macrolides' inhibition of CYP3A4 isoenzyme and OAT1B transporter causing increased exposure to statins. The correlation of this increased statin's exposure to the development of muscle toxicity could not be established, unless the patient had other risk factors such as advanced age, cardiovascular diseases, renal impairment, diabetes, and the concomitant use of other CYP3A4 inhibitors. Simvastatin, lovastatin, and to lesser extent atorvastatin are the statins most affected by this interaction. Rosuvastatin, fluvastatin, and pravastatin are not significantly affected by this interaction. Telithromycin, clarithromycin, and erythromycin are the most offending macrolides, while azithromycin appears to be safe to use with statins. This review presented a clear description of the clinical significance of this interaction in real practice. Also, it provided health care professionals with clear suggestions and recommendations on how to overcome this interaction. In conclusion, understanding the different characteristics of each statin and macrolide, as well as key patients' risk factors, will enable health care providers to utilize both groups effectively without compromising patient safety." @default.
• W2963758154 created "2019-07-30" @default.
• W2963758154 creator A5003144386 @default.
• W2963758154 creator A5066949699 @default.
• W2963758154 creator A5079293054 @default.
• W2963758154 date "2019-07-01" @default.
• W2963758154 modified "2023-10-14" @default.
• W2963758154 title "<p>The clinical significance of statins-macrolides interaction: comprehensive review of in vivo studies, case reports, and population studies</p>" @default.
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• W2963758154 doi "https://doi.org/10.2147/tcrm.s214938" @default.
• W2963758154 hasPubMedCentralId "https://www.ncbi.nlm.nih.gov/pmc/articles/6661989" @default.
• W2963758154 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/31413581" @default.
• W2963758154 hasPublicationYear "2019" @default.
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