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KMID : 0869620130300020095
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Journal of Korean Society of Hospital Pharmacists
2013 Volume.30 No. 2 p.95 ~ p.107
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Drug Use Evaluation of Statins Focused on Drug-Drug Interactions
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Choi Sun
Hwang Yu-Kyung
Lee Soo-Kyung
Park Eun-Ha
Han Ok-Youn
La Hyen-O
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Abstract
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Abstract : A retrospective, cross-sectional study was conducted to evaluate the actual incidence of statin-related adverse events due to drug-drug interaction (DDI) using the Clinical Decision Supporting System (CDSS) with a DDI alert module. Electronic medical records (EMR) were used to estimate the statin-related harmful DDI. We reviewed the full EMR of those patients (1) who were prescribed with statins from 01 January 2010 to 30 June 2011 and (2) whose prescription had a DDI alert message due to contraindicated concomitant drug use. Among 45,080 statin users, 221 (0.49%) patients had DDI alert messages related to their statins. The most frequently DDI alerted statin was rosuvastatin (189/221, 85.5%), and cyclosporine was the most frequently alerted concomitant medication (190/221, 86.0%). Based on the EMR review, 36 of 221 (16.3%) DDI alerted patients had DDI intervention by increasing the dosing intervals of statin (77.8%, 28/36).
Most DDI alerted patients had normal laboratory values in serum creatine kinase (CK) and in the liver function test. For the descriptive EMR records review, 3 patients had muscle symptoms sus-pected to be related to statin DDIs.
According to the results, contraindicated drug combinations related to statins and actual statinrelated myopathy were rare. However, most patients prescribed with statins could have multiple comorbid conditions; hence, health care professionals should consider different pharmacokinetic profiles of statins and different spectrum of drug interactions in order to select the optimal statin for the patient. Counseling the patients with regards to the risk and warning signs of myopathy and the possibility of drug interactions is also essential.
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KEYWORD
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Statin, Drug-drug interaction, Adverse drug reaction and myopathy
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