Cholesterol-lowering statins can
interact with other drugs prescribed for heart disease.
But there are ways to navigate the problem, according to
new recommendations from the American Heart Association.
The drugs are prescribed to people who either have
atherosclerosis or are at risk of it, which means many
statin users also take other cardiovascular drugs. The
benefits of those drug combinations will generally
outweigh the risks. But doctors and patients should be
aware of how the drugs can interact. A whole range of
heart medications can interact with statins, according
to the heart association. The list includes: cholesterol
drugs called fibrates, particularly gemfibrozil, blood
pressure medications called calcium channel blockers,
which include amlodipine, verapamil and diltiazem. Clot
preventing drugs such as warfarin and ticagrelor. Drugs
used to treat heart-rhythm problems, such as amiodarone,
dronedarone and digoxin. Heart failure medications like
ivabradine and sacubitril/valsartan. The most common
issue is that the other drugs boost statin levels in the
blood. That, in turn, raises the risk of muscle-related
side effects. Statins can injure muscle tissue, most
often causing muscle weakness or pain. Rarely, people
develop a more severe problem called rhabdomyolosis,
where the muscle fibers break down and may damage the
kidneys. There are a couple of other potential
consequences of statin interactions. Statins may, for
example, raise blood levels of the clot-preventing drug
warfarin, which could increase the risk of internal
bleeding. Many of the interactions between statins and
other heart drugs are "minor," and simply limiting the
statin dose is often enough, lead researcher added. But
there are some drug combinations that should be avoided.
Lovastatin, simvastatin and pravastatin should not be
used with the fibrate cholesterol drug gemfibrozil, for
example, because of the risk of muscle injury. Lead
researcher suggested that people talk to their doctor
any time they develop symptoms, like muscle weakness or
pain, that could be related to their statin or other
medications.
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