AHA Releases Statin, CVD Drug Interaction Management Recommendations

A new scientific statement from the American Heart Association (AHA), published in Circulation, provides guidance on how to manage the drug-drug interactions (DDIs) of statins with commonly prescribed heart disease drugs.

Studies have shown that statins reduce morbidity and mortality in patients with known cardiovascular disease and in many primary prevention patients. Because combination therapy with statins and other cardiovascular medications are prescribed in this patient population, potentially significant DDIs must be considered in patients treated with statins.

“While many of these drug combinations are safe, every patient is different and will tolerate medications differently. Patients need to be aware that interactions can occur and should speak to their health care providers about any unusual side effects or concerns,” said Barbara S Wiggins, PharmD, FAHA, chair of the writing committee of the AHA scientific statement, in a press release.
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For the statement, the writing committee examined combinations of statins and heart disease medications for potential interactions, and also noted changes needed in the labeling of some statin drugs with respects to DDIs. Cardiovascular medications examined included antiarrhythmic drugs, medications used in treating congestive heart failure, antiplatelet agents and anticoagulants, immunosuppressive agents, non-statin cholesterol-lowering agents, and calcium channel blockers.

The statement outlines specific doses at which certain heart disease medications can be used safely with statins as well as the combination of statins and certain heart medications that may be potentially harmful.

“Health care providers should be knowledgeable about the dose limits, adverse effects, and monitoring parameters associated with these DDIs to minimize toxicity,” concluded the writing committee. “A review of all medications that statin-treated patients are taking should be done at each clinical encounter and during transitions of care…so that DDIs can be identified early, evaluated, and managed appropriately by implementing doses adjustments, changing to a safer statin medication, or discontinuing when needed.”—Eileen Koutnik-Fotopoulos