Lovastatin Calcium-channel blockers

CALCIUM CHANNEL BLOCKERS STATINS t plasma levels of atorvastatin, lovastatin and simvastatin case reports of myopathy when atorvastatin and simvastatin are co-administered with diltiazem or verapamil Uncertain, but postulated to be due to inhibition of CYP3A4-mediated metabolism of statins in the intestinal wall. Also, diltiazem and verapamil inhibit intestinal P-gp, which may t the bioavailability of statins Watch for side-effects of statins. It has been suggested that the dose of simvastatin should not exceed 20 mg when given with verapamil, and 40 mg when given with diltiazem... 

Benzodiazepines alprazolam, clonazepam, diazepam, midazolam, triazolam, zolpidem Calcium channel blockers diltiazem, nifedipine, nimodipine, verapamil Steroids androgens, estrogens, cortisol Others erythromycin, terfenadine, cyclosporine, dapsone, ketoconazole, lovastatin, lidocaine, alfentanil, amiodarone, astemizole, codeine, sildenafil... 

Modafinil is an inducer of the cytochrome P450 isoenzyme CYP3A4. The manufacturers therefore predict that it may reduce the levels of drugs that are CYP3A4 substrates. They specifically name the protease inhibitors, buspirone, calcium-channel blockers, ciclosporin, midazolam, and the statins [note that only some statins, namely atorvastatin, lovastatin and... 

Marked rises in statin plasma levels have been seen when lovastatin or simvastatin were given with diltiazem, and when simvastatin was given with verapamil. Isolated cases of rhabdomyolysis have occurred as a result of these interactions. However, overall, it seems that problems with combinations of statins and calcium-channel blockers (particularly the dihydropyridine-type) are rare. 

A retrospective study of the effects of lovastatin and antihypertensive medication found that when calcium-channel blockers (diltiazem, nifedipine or verapamil) were used in combination with lovastatin there was an additional 3 to 5% lowering in the LDL-cholesterol, which was of marginal significance. Pharmacokinetic studies have shown that oral diltiazem increases the AUC and maximum serum levels of lovastatin by about fourfold. In another study, lovastatin 20 mg and isradipine 5 mg... 

Drug-drug interactions Lovastatin There have been reports of the effects of calcium channel blockers on the pharmacokinetics of HMG-CoA reductase inhibitors, but there is relatively less information on the effect of HMG-CoA reductase inhibitors on the pharmacokinetics of calcium channel blockers. The pharmacokinetics of verapamil and norverapamil have been compared in 14 healthy men who took oral verapamil 60 mg with and without oral... 

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