Identify and Assess Drug Interactions with Atorvastatin in Inpatient Care

Background: Atorvastatin is a recent HMG-COA reductase inhibitor used to treat primary hypercholesterolemia, homozygous familial hypercholesterolemia, and mixed dyslipidemias. It is also taken to prevent heart disease, including strokes and heart attacks. In addition, Atorvastatin is used to lower bad cholesterol low-density lipoproteins (LDL) levels, increase good cholesterol high-density lipoprotein (HDL) levels, and lower triglycerides. It works by reducing the amount of cholesterol produced in the body, hence reducing the amount of cholesterol that may build up on the walls of arteries. Atorvastatin is long-acting, has few adverse effects, and is low in price. Nevertheless, it interacts with a wide variety of medications. These interactions may be lead to adverse drug reactions.

Objective: The study aims to identify and asset atorvastatin interactions with other medicines at King Abdulaziz Hospital. Also, to prevent atorvastatin interactions in the future.

Methods: The retrospective study investigated 280 electronic prescriptions inside the inpatient clinic at King Abdulaziz Hospital in Saudi Arabia between January and April 2021 to identify and asset interactions among atorvastatin and different medications.

Results: Most atorvastatin interactions are category C (44.64%) and category B (41.43%). Atorvastatin had the most common interactions with esomeprazole (16.07%), clopidogrel (14.64%), and sitagliptin (12.14%). Atorvastatin had clinical interactions with medications metabolized by the cytochrome P450 3A4 )CYP3A4(. Use of atorvastatin with cyclosporine or clarithromycin increased the risk for atorvastatin toxicities such as myopathy and rhabdomyolysis. In addition, Atorvastatin decreases clopidogrel's antiplatelet effect and increases the risk of skeletal muscle toxicity of daptomycin.

Conclusion: The majority of atorvastatin interactions may be avoided by adhering to best practices in clinical care and clinical pharmacology, such as avoiding complicated treatment regimens, utilizing a single pharmacy for all prescriptions, and recognizing patient risk factors. Health care professionals should use drug-drug interaction checkers such as Medscape and Micromedex, as well as a book such as the Handbook of Drug Interactions.