Rosuvastatin-associated副作用和血脂异常的临床药物之间的相互作用。

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Rosuvastatin-associated副作用和血脂异常的临床药物之间的相互作用。

点J Cardiovasc药物。2010;10 (1):11-28。doi: 10.2165 / 13168600-000000000-00000。

PubMed ID

20104931 (在PubMed

]

文摘

β-还原酶抑制剂(他汀类药物)是血脂异常的药物管理的主体。因为它们是普遍规定,他们的安全仍然是一个关心的问题。伐已经被证明是有效的在改善血清血脂水平。木星最近公布的数据证实他汀类药物的疗效研究初级预防老年患者的多个风险因素和炎症的证据。伐展品高亲水性和hepatoselectivity以及系统生物利用度低,而通过细胞色素P450系统接受最小的新陈代谢。因此,伐他有一个有趣的不同于其他他汀类药物的药动学特征。然而,这还有待建立这可能转化为一个更好的安全性和更少的这个他汀类药物之间的相互作用与他人相比。,我们审查证据对他汀类药物的安全性以及它与制剂在临床常用的交互。与其他他汀类药物一样,伐治疗与相对较低的利率严重的肌病,横纹肌溶解和肾功能衰竭。无症状的肝酶与普伐海拔发生类似的低发病率与其他他汀类药物。 Rosuvastatin treatment has also been associated with adverse effects related to the gastrointestinal tract and central nervous system, which are also commonly observed with many other drugs. Proteinuria induced by rosuvastatin is likely to be associated with a statin-provoked inhibition of low-molecular-weight protein reabsorption by the renal tubules. Higher doses of rosuvastatin have been associated with cases of renal failure. Also, the co-administration of rosuvastatin with drugs that increase rosuvastatin blood levels may be deleterious for the kidney. Furthermore, rhabdomyolysis, considered a class effect of statins, is known to involve renal damage. Concerns have been raised by findings from the JUPITER study suggesting that rosuvastatin may slightly increase the incidence of physician-reported diabetes mellitus, as well as the levels of glycated hemoglobin in older patients with multiple risk factors and low-grade inflammation. Clinical trials proposed no increase in the incidence of neoplasias with rosuvastatin treatment compared with placebo. Drugs that antagonize organic anion transporter protein 1B1-mediated hepatic uptake of rosuvastatin are more likely to interact with this statin. Clinicians should be cautious when rosuvastatin is co-administered with vitamin K antagonists, cyclosporine (ciclosporin), gemfibrozil, and antiretroviral agents since a potential pharmacokinetic interaction with those drugs may increase the risk of toxicity. On the other hand, rosuvastatin combination treatment with fenofibrate, ezetimibe, omega-3-fatty acids, antifungal azoles, rifampin (rifampicin), or clopidogrel seems to be safe, as there is no evidence to support any pharmacokinetic or pharmacodynamic interaction of rosuvastatin with any of these drugs. Rosuvastatin therefore appears to be relatively safe and well tolerated, sharing the adverse effects that are considered class effects of statins. Practitioners of all medical practices should be alert when rosuvastatin is prescribed concomitantly with agents that may increase the risk of rosuvastatin-associated toxicity.

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