Drug Interactions of Lipid Lowering Drugs (Part 6):

Drug Interactions of Lomitapide:

More presentations from Naina Mohamed Pakkir Maideen
 

©   Lomitapide is an Orphan drug approved to reduce LDL cholesterol, total cholesterol, apolipoprotein B, and non-high-density lipoprotein (non-HDL) cholesterol in patients with Homozygous familial hypercholesterolemia (HoFH).

©   Mechanism of Action of Lomitapide:

©   Lomitapide may interact majorly with drugs such as CYP3A4 Inhibitors (Azole antifungals – Ketoconazole, Macrolide antibiotics – Clarithromycin, etc), Simvastatin or Lovastatin and Warfarin and Grapefruit Juice and Alcohol.

©   Lomitapide may also interact with Grapefruit Juice (GFJ) and Alcohol.

©   The concomitant use of Lomitapide and a CYP3A4 inhibitor such as (Azole antifungals – Ketoconazole, Macrolide antibiotics – Clarithromycin, etc), is contraindicated. 
©  Concomitant use of Lomitapide and Simvastatin or Lovastatin, warrants the monitoring of patients for the symptoms of myopathy.
© The INR of the patients receiving concurrent lomitapide and Warfarin therapy, should be monitored regularly and adjust warfarin dose accordingly.
© Patients receiving lomitapide should avoid the ingestion of Grapefruit juice (GFJ).
© The patients taking lomitapide should be instructed about the elevated risk of liver injury associated to Alcohol.

©   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 Lipid Lowering Drugs (Part 5):

Drug Interactions of Ezetimibe:

More presentations from Naina Mohamed Pakkir Maideen

©   Ezetimibe is used as second line therapy to treat high LDL cholesterol levels in patients who are intolerant to statins or who are unable to achieve target with statins alone.

©   Mechanism of Action of Ezetimibe:

©   Ezetimibe can interact majorly with Fibrates (Gemfibrozil, Clofibrate, etc) and moderately with Bile acid sequestrants (Cholestyramine, Colestipol, Colesevelam), Warfarin and Cyclosporine.

©   Coadministration of Ezetimibe and a Fibrate except fenofibrate, is not recommended.

©   To minimize reductions in ezetimibe bioavailability, Ezetimibe should be administered at least two hours before or four hours after Bile acid sequestrants such as Cholestyramine, Colestipol and Colesevelam.

©   Frequent monitoring of Prothrombine Time or INR is recommended, if ezetimibe and warfarin are used concomitantly. Warfarin dosage should be adjusted accordingly.

©   Monitor for signs and symptoms of ezetimibe toxicity including abdominal, back or headache pain, fatigue, diarrhea, sinusitis, and cough when Ezetimibe and Cyclosporine are used concomitantly.

©   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.