Tuesday, 21 June 2016

Drug Interactions of Lipid Lowering Drugs (Part 2):

Drug Interactions of Fibrates:




More presentations from Naina Mohamed Pakkir Maideen


©   Fibrates (Fibric acid derivatives) include Gemfibrozil, Clofibrate, Ciprofibrate, Fenofibrate and Bezafibrate.
©   Fibrates are used as the firstline drugs to treat primary hypertriglyceridemia.
©   Mechanism of Action of Fibrates:
Mechanism of action of Fibrates

©   It is contraindicated to use Ciprofibrate with other Fibrates and Gemfibrozil with Repaglinide, Simvastatin or Dasabuvir, concomitantly.
©   Fibrates can interact majorly with drugs such as Ezetimibe and Sulfonylurea Antidiabetics (Glyburide, Glipizide, Glimepiride, etc).
©   The major interactions of Gemfibrozil include Other Statins (Lovastatin, Atorvastatin, Fluvastatin, Pravastatin) and Colchicine.
©   The concomitant use of Fibrates and Ciprofibrate is contraindicated due to an increased risk of rhabdomyolysis and myoglobulinuria.
©   To avoid cholelithiasis, the coadministration of Ezetimibe and fibrates (except Fenofibrate), is not recommended.
©   Close monitoring of blood glucose is recommended, if Fibrates and Sulfonylurea Antidiabetics (Glyburide, Glipizide, Glimepiride, etc) are used concurrently.
©   Due to elevated risk of hypoglycemia, the combined use of Gemfibrozil and Repaglinide, is contraindicated.
©   The concomitant use of Gemfibrozil and Simvastatin may increase the risk of developing myopathy or rhabdomyolysis and is contraindicated.
©   Concomitant use of Dasabuvir and Gemfibrozil is contraindicated due to a 10-fold increase in dasabuvir exposure and an increased risk of QT prolongation.
©   The concomitant use of Gemfibrozil and Statins should be avoided, if possible.
©   Patients receiving Gemfibrozil and Colchicine should be monitored closely for signs and symptoms of myopathy or rhabdomyolysis.
©   Concomitant use of Fenofibrate and Anticoagulants,  requires the monitoring of INR value.
©   The interaction between Bezafibrate and Bile acid Sequestrants (Cholestyramine, Colestipol, Colesevelam)  can be avoided by separating the administration of the two drugs by at least 2 hours.
©   The occurrence of significant morbidity and mortality can be reduced by minimizing the risk for drug interactions.
©   The hyperlipidemic patients should bring a list of all the drugs they are taking including prescription drugs, over-the-counter drugs, and any supplements, herbal or otherwise, during their visit to the doctor or pharmacist.
©   The risk of adverse effects could be reduced and the quality of life for patients improved by healthcare professionals through the screening, education, and follow up on suspected drug interactions.
©   If possible, the hyperlipidemic patients are recommended to fill all their prescriptions at one pharmacy.

Drug Interactions of Thiazide Diuretics:

https://www.researchgate.net/publication/342864519_Pharmacodynamic_interactions_of_thiazide_diuretics http://www.ijmdc.com/?mno=51031...