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Amlodipine and atorvastatin and Ketek

Determining the interaction of Amlodipine and atorvastatin and Ketek and the possibility of their joint administration.

Check result:
Amlodipine and atorvastatin <> Ketek
Relevance: 05.06.2023 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

Talk to your doctor before using atorvastatin together with telithromycin. Combining these medications may significantly increase the blood levels of atorvastatin. This can increase the risk of side effects such as liver damage and a rare but serious condition called rhabdomyolysis that involves the breakdown of skeletal muscle tissue. In some cases, rhabdomyolysis can cause kidney damage and even death. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications, or your doctor may prescribe alternative medications that do not interact. Let your doctor know immediately if you have unexplained muscle pain, tenderness, or weakness during treatment with atorvastatin or similar medications, especially if these symptoms are accompanied by fever or dark colored urine. You should also seek immediate medical attention if you develop fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, dark colored urine, and/or yellowing of the skin or eyes, as these may be signs and symptoms of liver damage. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Professional:

GENERALLY AVOID: Coadministration with telithromycin may significantly increase the plasma concentrations of HMG-CoA reductase inhibitors that are metabolized by CYP450 3A4 such as atorvastatin, cerivastatin, lovastatin, and simvastatin. The mechanism is decreased clearance due to inhibition of CYP450 3A4 activity by telithromycin. Coadministration of telithromycin and simvastatin has resulted in a 5.3-fold increase in the simvastatin peak plasma concentration (Cmax), an 8.9-fold increase in the simvastatin systemic exposure (AUC), a 15-fold increase in the simvastatin acid (an active metabolite) Cmax, and a 12-fold increase in the simvastatin acid AUC. These values were still increased 3- to 4-fold when the drugs were administered 12 hours apart. High levels of HMG-CoA reductase inhibitory activity in plasma is associated with an increased risk of musculoskeletal toxicity. Myopathy manifested as muscle pain and/or weakness associated with grossly elevated creatine kinase exceeding ten times the upper limit of normal has been reported occasionally. Rhabdomyolysis has also occurred rarely, which may be accompanied by acute renal failure secondary to myoglobinuria and may result in death.

MANAGEMENT: The use of telithromycin should be avoided in patients treated with atorvastatin, lovastatin, red yeast rice (which contains lovastatin), and simvastatin due to the potential for severe interaction. If telithromycin is prescribed in such patients, HMG-CoA reductase inhibitor therapy should be suspended until after completion of telithromycin treatment. Fluvastatin, pravastatin, and rosuvastatin are not expected to interact with telithromycin, since they are not metabolized by CYP450 3A4. All patients receiving statin therapy should be advised to promptly report any unexplained muscle pain, tenderness or weakness, particularly if accompanied by fever, malaise and/or dark-colored urine. Therapy should be discontinued if creatine kinase is markedly elevated in the absence of strenuous exercise or if myopathy is otherwise suspected or diagnosed.

References
  • Garnett WR "Interactions with hydroxymethylglutaryl-coenzyme A reductase inhibitors." Am J Health Syst Pharm 52 (1995): 1639-45
  • "Product Information. Lipitor (atorvastatin)." Parke-Davis, Morris Plains, NJ.
  • East C, Alivizatos PA, Grundy SM, Jones PH, Farmer JA "Rhabdomyolysis in patients receiving lovastatin after cardiac transplantation." N Engl J Med 318 (1988): 47-8
  • Ayanian JZ, Fuchs CS, Stone RM "Lovastatin and rhabdomyolysis." Ann Intern Med 109 (1988): 682-3
  • "Product Information. Ketek (telithromycin)." Aventis Pharmaceuticals, Bridgewater, NJ.
  • Omar MA, Wilson JP "FDA adverse event reports on statin-associated rhabdomyolysis." Ann Pharmacother 36 (2002): 288-95
  • Huynh T, Cordato D, Yang F, et al. "HMG coA reductase-inhibitor-related myopathy and the influence of drug interactions." Intern Med J 32(9-10) (2002): 486-90
  • "Product Information. Mevacor (lovastatin)." Merck & Co, Inc, West Point, PA.
  • Williams D, Feely J "Pharmacokinetic-Pharmacodynamic Drug Interactions with HMG-CoA Reductase Inhibitors." Clin Pharmacokinet 41 (2002): 343-70
  • Neuvonen PJ, Backman JT, Niemi M "Pharmacokinetic comparison of the potential over-the-counter statins simvastatin, lovastatin, fluvastatin and pravastatin." Clin Pharmacokinet 47 (2008): 463-74
  • "Product Information. Zocor (simvastatin)." Merck & Co, Inc, West Point, PA.
  • Ayanian JZ, Fuchs CS, Stone RM "Lovastatin and rhabdomyolysis." Ann Intern Med 109 (1988): 682-3
  • European Agency for the Evaluation of Medicinal Products. Committee for Proprietary Medicinal Products "European Public Assessment Report Ketek (telithromycin) (Rev. 2) Available from: URL: http:www.emea.eu.int/humandocs/Humans/EPAR/Ketek/Ketek.htm." ([2001]):
  • "Product Information. Baycol (cerivastatin)." Bayer, West Haven, CT.
  • Corpier CL, Jones PH, Suki WN, et al. "Rhabdomyolysis and renal injury with lovastatin use. Report of two cases in cardiac transplant recipients." JAMA 260 (1988): 239-41
Amlodipine and atorvastatin

Generic Name: amlodipine / atorvastatin

Brand name: Caduet

Synonyms: Amlodipine and Atorvastatin

Ketek

Generic Name: telithromycin

Brand name: Ketek

Synonyms: n.a.

In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

Interaction with food and lifestyle
Disease interaction