No Interaction Seen Between Clopidogrel and Statins

Secondary analysis of CHARISMA study suggests that co-administration of two drugs is safe

WEDNESDAY, July 18 (HealthDay News) -- Contrary to concerns that certain statins may reduce the effectiveness of clopidogrel because both are metabolized by CYP3A4, there is no evidence that the drugs interact, according to a report in the July 24 issue of the Journal of the American College of Cardiology.

Jacqueline Saw, M.D., of the University of British Columbia in Vancouver, Canada, and colleagues performed a secondary analysis of the CHARISMA study, in which 10,078 of the 15,603 enrollees received clopidogrel and a statin, some that were metabolized by CYP3A4 (atorvastatin, lovastatin, simvastatin) and some not (pravastatin, fluvastatin).

After a median follow-up of 28 months, the researchers found that rates for the primary end point -- a composite of myocardial infarction, stroke, or cardiovascular death -- were similar among patients taking a CYP3A4-metabolized statin and clopidogrel (5.9 percent statin/clopidogrel versus 6.6 percent statin/placebo) and other statins (5.7 percent statin/clopidogrel versus 7.2 percent statin/placebo).

"Data currently available suggest that clopidogrel response variability is clinically more important than the possibility of interaction with other CYP3A4-metabolized drugs," state the authors of an accompanying editorial. "Therefore, clinicians should continue to prescribe clopidogrel and statins where clinically indicated and disregard selecting statins on the basis of CYP3A4 metabolism. Nevertheless, prospective studies are still required to fully elucidate the potential clinical impact of coadministration of CYP3A4-metabolized drugs, including clopidogrel and lipophilic statins."

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