AHA Addresses Potential Interactions Between Statins and Common Heart Drugs

Harmful combinations and safe doses identified

A new scientific statement from the American Heart Association (AHA) aims to provide guidance on how to manage the drug interactions of cholesterol-lowering statins with other select heart disease medications.

“Health care providers and their patients who take statins need to be aware that these medications could interact with their other heart disease medications, such as medications to control blood pressure, treat abnormal heart rhythms, and others,” said Barbara S. Wiggins, PharmD, chair of the writing committee of the new scientific statement published in the AHA journal Circulation.

“While many of these drug combinations are safe, every patient is different and will tolerate medications differently. Patients need to be aware that interactions can occur and should speak to their health care providers about any unusual side effects or concerns,” said Wiggins, a clinical pharmacy specialist in cardiology at the Medical University of South Carolina in Charleston.

 Drug interactions occur when medications are combined and their interaction alters the effect of one or both drugs, either by enhancing or decreasing the effect of the drug. An estimated 2.8% of all hospital admissions are attributed to drug interactions, but that number could be higher because medication-related issues are often reported as adverse drug reactions, and underlying conditions (e.g., thyroid disease, rheumatologic disease) may disguise drug interactions.

Statins are prescribed to patients with hardening of the arteries, or atherosclerosis, and those at high risk for developing atherosclerosis, making it likely that statins will be prescribed in combination with other heart disease medications. The writing committee of the statement examined combinations of these drugs for potential interactions, and also highlighted changes needed in the labeling of some statin drugs with respect to drug interactions since they were initially placed on the market.

The types of cardiovascular medications the writing committee examined included:

  • Antiarrhythmic drugs, used to treat abnormal heart rhythms;
  • Medications used in treating congestive heart failure;
  • Antiplatelet agents and anticoagulants that are used to thin the blood;
  • Immunosuppressive agents, for patients who have undergone a heart transplant;
  • Nonstatin cholesterol lowering agents; and
  • Calcium-channel blockers, commonly used to treat high blood pressure.

The statement identifies specific doses at which certain heart disease medications can be used safely with statins as well as the combinations of statins and certain cardiac medications that may be potentially harmful.

Source: AHA; October 17, 2016.