Statins Interaction Potencies

Sukamto S M
Lipid Metabolism
Statins as HMG-CoA Reductase Inhibitor

Acetoacetyl
Acetyl Co-A HMG-CoA Mevalonic acid
Co-A

HMG-CoA HMG-CoA
synthase Statins
reductase Farnesyl
pyrophosphate

Squalene

Prenylated
Ubiquinone Cholesterol
proteins
Statins as HMG-CoA Reductase Inhibitor
 Statins
• Hydrophilic statins • Lipophilic statins (act
(mostly act in the liver) throughout the body)
– Rosuvastatin – Simvastatin
– Fluvastatin – Atorvastatin
– Pravastatin – Lovastatin

• Statins are associated with myopathy in 1% - 5% of

patients who are taking statins.
• This adverse effect can lead to rhabdomyolisis and
will finally end up in renal disease.
The drugs having potency to be interacted
with statins

 Drugs having potency to cause myopathy 

Colchicine, fibric acid derivatives, niacin
 CYP3A4 inducers  Carbamazepine, phenytoin,
barbiturates
 CYP3A4 inhibitors  Amiodarone, azoles,
cyclosporine, macrolides, protease inhibitors and
CCB.
 Several CYP2C9 inhibitor in case of fluvastatin 
fenofibrate, omeprazole, amiodarone
 Drugs having inhibition effect on P-glycoprotein 
cyclosporine, diltiazem, dronedarone, cholchicine,
grapefruit juice
The drugs having potency to be interacted
with statins

 Drugs having inhibition effect on OATP 

Cyclosporine, dronedarone,.
 Steroids  This group will induce lipid
production in the liver.
 Hepatotoxic drugs  They can disturb statins
effects on the liver.
 Nephrotoxic drugs  They can worsen
nephrotoxic effect of statins.
 How if statins is administered to the pregnant
woman?
Tugas
 Setiap kelompok WAJIB memiliki 1 resep yang
memuat MINIMAL 3 item obat
 Dari 3 item obat tersebut, MINIMAL 1 obat
adalah psikotropika
 Bahas potensi interaksi yang terjadi antar
psikotropika dan obat lain yang terdapat dalam
resep itu.
 Pembahasan dibuat dalam makalah sederhana
dengan mencantumkan referensi valid.
 Hasil pembahasan kemudian dipresentasikan.
 Tugas dikumpul dan akan dibahas minggu depan.
Thank you