The interaction between fluvastatin and warfarin

Abstract

Statin is one kind of 3-hydroxy-3-methyl-glutaryl-CoA reductase (HMG-CoA reductase) inhibitor and meanwhile the most widely used medication prescribed for cardiovascular disease and dyslipidemia. Fluvastatin is believed to be safe in the elderly, renal insufficiency, heart failure and those who accepted renal or heart transplantation [ 1 Bruckert E. Lièvre M. Giral P. et al. Short-term efficacy and safety of extended-release fluvastatin in a large cohort of elderly patients. Am J Geriatr Cardiol. 2003; 12 ([Jul–Aug.]): 225-231 Google Scholar , 2 Celik T. Iyisoy A. Dogru M.T. Isik E. Statin use in chronic heart failure: waiting for the results of large prospective outcome trials. Int J Cardiol. 2009; 132: 122-124 Google Scholar , 3 Gürgün C. Ildizli M. Yavuzgil O. et al. The effects of short term statin treatment on left ventricular function and inflammatory markers in patients with chronic heart failure. Int J Cardiol. 2008; 123: 102-107 Google Scholar , 4 Holdaas H. Wanner C. Abletshauser C. Gimpelewicz C. Isaacsohn J. The effect of fluvastatin on cardiac outcomes in patients with moderate to severe renal insufficiency: a pooled analysis of double-blind, randomized trials. Int J Cardiol. 2007; 117: 64-74 Google Scholar , 5 Launay-Vacher V. Izzedine H. Deray G. Statins' dosage in patients with renal failure and cyclosporine drug–drug interactions in transplant recipient patients. Int J Cardiol. 2005; 101: 9-17 Google Scholar ]. Warfarin is applied in patients with atrial fibrillation (Af), arterial or venous thromboembolism. The combined use of statin and warfarin is common, one study had demonstrated statistic meaningful data suggested statin on preventing Af [ [6] Adabag A.S. Nelson D.B. Bloomfield H.E. Effects of statin therapy on preventing atrial fibrillation in coronary disease and heart failure. Am Heart J. 2007; 154 ([Dec.]): 1140-1145 Google Scholar ]. However, the interaction between these two drugs had only been discussed in very few papers [ [7] Trilli L.E. Kelley C.L. Aspinall S.L. Kroner B.A. Potential interaction between warfarin and fluvastatin. Ann Pharmacother. 1996; 30 ([Dec.]): 1399-1402 Google Scholar ]. The drug–drug interactions need to be explored to provide a better drug safety.