The results also showed that reviewing spontaneous reports can add information to drug interactions not established previously.In general, 3‐hydroxy‐3‐methylglutaryl coenzyme A reductase inhibitors (statins) are well tolerated by most users The WHO Collaborating Centre for International Drug Monitoring, the Uppsala Monitoring Centre (UMC), based in Uppsala, Sweden, collects spontaneously reported cases of suspected ADRs.
Atorvastatin, lovastatin and simvastatin were all reported more frequently than expected with azithromycin and rhabdomyolysis. Patients in both groups were well matched for demographics, comorbidities, statin dose, and concurrent medications. It is observed that azithromycin if given with statins, may cause severe rhabdomyolysis which may lead to an acute renal shutdown. Azithromycin has previously been described not to interact with statins It is noteworthy that the reports were not restricted exclusively to the elderly (e.g.
azithromycin in 23% of cases.
Expert panelists review the causes, diagnostic work-up, management, and emerging therapies inherent in the evolving paradigm of irritable bowel syndrome.Statins and Macrolide Antibiotics: Defining the RiskJohn R. Horn, PharmD, FCCP, And Philip D. Hansten, PharmD, RPhStatins and Macrolide Antibiotics: Defining the RiskThe potential severity of these uncommon interactions warrants measures to avoid them. It isn't uncommon to take a short "break" on a "statin" drug like Lipitor if you were prescribed azithromycin but there are several factors to take into account.
The limited evidence base, in combination with our results, motivates further studies of this potential interaction. An individual participant data meta-analysis, Muscular Adverse Drug Reactions Associated with Proton Pump Inhibitors: A Disproportionality Analysis Using the Italian National Network of Pharmacovigilance Database, Appropriate risk criteria for OATP inhibition at the drug discovery stage based on the clinical relevancy between OATP inhibitors and drug-induced adverse effect, Pregabalin- and azithromycin-induced rhabdomyolysis with purpura: An unrecognized interaction: A case report, The Development and Evaluation of Triage Algorithms for Early Discovery of Adverse Drug Interactions, Rhabdomyolysis secondary to influenza A H1N1 vaccine resulting in acute kidney injury, Key Elements in Adverse Drug Interaction Safety Signals, Polypharmacy in the elderly from the clinical toxicologist perspectivePolypharmazie beim älteren Patienten aus Sicht des klinischen Toxikologen, Managing the underestimated risk of statin-associated myopathy, Rhabdomyolysis caused by an unusual interaction between azithromycin and simvastatin, Reporting Patterns Indicative of Adverse Drug Interactions, A worldwide yearly survey of new data in adverse drug reactions, Pharmacokinetic as well as pharmacodynamic interactions may be involved In conclusion, our study has demonstrated the usefulness of the newly developed disproportionality measure, Omega, in order to identify drug interactions in spontaneous reporting datasets.
>65 years The observed number cases reported for rhabdomyolysis with azithromycin and the individual statins is two to three times greater than the expected number of cases, which leads to positive Omega values, as well as positive lower 95% credibility intervals (Since muscular and liver function disorders may have a similar mechanism involved as rhabdomyolysis, these associations were also analysed (results not shown). The expected number of cases is the number of reports, which we expect to be reported for the drug–drug–ADR (DDA).No measure has yet been shown effective in highlighting emerging drug–drug interactions. A case reported by Dr Gaurav Alreja shows a possible interaction of azithromycin with simvastatin, A 73 years old male who was given azithromycin for bronchitis, he was taking simvastatin. The IC measure in conjunction with triage filters The analysis presented in this study is based on a measure of interaction, related to the IC, which is referred to as Omega, and contrasts the observed relative reporting rate in the database with its expected value estimated from the relative reporting rates of the ADR given and with the individual reporting of each drug. © 2020 The British Pharmacological Society Effects of HMG‐coa reductase inhibitors on skeletal muscle: are all statins the same?Interactions between statins and macrolide antibioticsThe Medicines Compendium.
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