Statins Rifampicin

Fluvastatin has been reported to interact with rifampicin, causing increased clearance of the statin. Rifampicin is an inducer of the CYP 450 3A4 isoenzyme and may increase the rate of clearance of statins that are substrates for 3A4. 

STATINS RIFAMPICIN Rifampicin may lower fluvastatin and simvastatin levels Uncertain Monitor lipid profile closely look for poor response to fluvastatin and simvastatin... 

Drug interactions The extent to which vitamin D supplementation alters drug effectiveness and toxicity in humans has been systematically reviewed. Bile acid sequestrants and lipase inhibitors were found to inhibit the absorption of vitamin D from the gut. Statins, rifampicin, isoniazid, hydroxychloroquine, antiepileptics, corticosteroids, immimo-suppressive and chemotherapeutic agents, antiretroviral drugs and H2 receptor antagonists interfered with vitamin D metabolism. The interaction between vitamin D and thiazide diuretics could result in hypercalcaetnia. Vitamin D supplementation decreases concentrations of atorvastatin, and could cause hypercalcaetnia in elderly individuals or tixose with compromised renal function or hyperparathyroidism [84 ]. 

The authors of a major review of rosuvastatin concluded that its adverse reaction profile resembles that of other commonly used statins [34 ]. Increments in fiver enzymes are in most cases minor and of minimal concern, renal dysfunction is quite uncommon, myopathy is unusual, and rhab-domyolysis is rare. Interactions with other drugs are fisted but no new information given. Combinations with fenofibrate, omega-3 fatty acids, ezetimibe, rifampicin, and clopidogrel appear to be safe. 

A case report of severe rhabdomyolysis leading to death highlighted the risks of combining statins with fusidic acid. In this case, rifampicin was administered with fusidic acid in an elderly man following total hip revision surgery [153 ]. 

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