Why Statins and Plavix are administered together?
Clopidogrel and statins are frequently coadministered in patients with ischemic heart diseases. The possibility of a drug-drug interaction between certain statins and clopidogrel has been extensively investigated in the literature recently. Investigators have proposed that the use of statins that are metabolized by the cytochrome P450 (CYP) system may diminish the conversion of clopidogrel to its active form by inhibiting the CYP3A4 isoenzyme. This inhibition could result in a decreased antiplatelet effect of clopidogrel, which could translate into an increased risk of cardiovascular events.
Not all statins interfere with clopidogrel during antiplatelet therapy
In a recent study the finding were stunning, all statins, except pravastatin, were detectable in the plasma at the end of each treatment period in all patients, and no statin was detectable after any of the wash-out periods. Clopidogrel was significantly less efficient to prevent platelet aggregation when coadministrated with simvastatin or fluvastatin. No difference was observed in clopidogrel efficacy when coadministered with rosuvastatin, pravastatin or atorvastatin. Source
Can you take atorvastatin and Plavix together?
Talk to your doctor before using atorvastatin and clopidogrel. This combination may reduce the effects of clopidogrel. Call your doctor promptly if you have any signs of blood clots such as chest pain, shortness of breath, sudden loss of vision, or pain, redness or swelling in an extremity.
Which medications should be avoided with statins (co-administration)
- Antacids containing magnesium or aluminum hydroxide may decrease the concentration of some statins in the body. This may be prevented by taking your statin dose and antacid dose at least two hours apart.
- Antibiotics ending in -mycin such as erythromycin or Biaxin (clarithromycin) may increase the statins present in the blood and may also increase side effects.
- Antifungal drugs ending in -azole, such as Nizoral (ketoconazole), Diflucan (fluconazole), Mycelex (miconazole), or Sporanox (itraconazole), may increase the amount of some statins in the blood. It may also increase statin side effects.
- Bile acid sequestrants may decrease the effectiveness of some statins. To avoid this, it may be recommended to take your statin dose and bile acid sequestrant dose at least four hours apart.
- Cordarone (amiodarone) may increase the amount of some statins present in the blood. It may also increase the side effects of statins.
- Coumadin (warfarin) along with a statin may reduce the blood’s ability to clot.
- Fibrates may increase the risk of experiencing statin side effects.
- Fluvoxamine may increase the concentration of some statins present in the blood. It may also increase statin side effects.
- High blood pressure medications which are calcium channel blockers, such as diltiazem and verapamil, lower blood pressure but may also increase the statins present in the blood. They may also increase side effects.
- HIV protease inhibitors, such as Norvir (ritonavir), Agenerase (amprenavir), Crixivan (indinavir), or Viracept (nelfinavir), may increase the amount of some statins present in the blood. They may also increase side effects.
- Lanoxin (digoxin) may increase the concentration of some statins in the body.
- Nicotinic acid (niacin) in high doses (greater than 1 gram a day) could increase the risk of experiencing statin side effects.
- Oral contraceptives and statins that are taken simultaneously may increase the concentration of these hormones in the body.
- Prilosec (omeprazole) may increase the amount of some statins present in the blood. It may also increase the side effects of statins.
- Sandimmune (cyclosporine) may increase the number of statins present in the blood and may also increase side effects.
- St. John’s Wort may decrease the effectiveness of some statins.
- Tagamet (cimetidine) may increase the amount of some statins present in the blood and may also increase the side effects of statins.
- Zantac (ranitidine) may increase the amount of some statins present in the blood and may also increase the side effects of statins.