Statin Interaction Reference

Your EMR, Epocrates, Lexicomp and your local pharmacy may give you four different opinions on which drugs interact (and how much) with each other.

A week or so ago I did a physical on a patient on simvastatin with chronic gout. My EMR flagged a major interaction between simvastatin and colchicine. Epocrates had something bad to say about the combination of any statin I tried with colchicine. I decided to stew about it for a while.

Today I asked Dr. Google, and he served up what I wished I had heard about it when it was first published: An AHA statement about more than a dozen statin Drug-Drug interactions.

It turns out rosuvastatin has only one pathway for interaction with colchicine while simvastatin and atorvastatin have two, making rosuvastatin “reasonable”.

Whew…

Thanks, AHA, and thanks, Dr. Google!

“Coadministration of colchicine and rosuvastatin, fluvastatin, lovastatin, pitavastatin, and pravastatin is reasonable when clinically indicated. Dose reductions may be considered for atorvastatin, simvastatin, and lovastatin, given the potential for interactions mediated by both CYP3A4 and permeability glycoprotein (P-gp) pathways.”

https://www.acc.org/latest-in-cardiology/ten-points-to-remember/2016/10/20/21/53/recommendations-for-management-of-clinically-significant-drug