TY - JOUR

T1 - Drug-drug interactions between vitamin K antagonists and statins

T2 - a systematic review

AU - Engell, Anna E.

AU - Svendsen, Andreas L.O.

AU - Lind, Bent S.

AU - Stage, Tore Bjerregaard

AU - Hellfritzsch, Maja

AU - Pottegård, Anton

PY - 2021

Y1 - 2021

N2 - Purpose: Concomitant use of vitamin K antagonists (VKA) and statins is frequent in cardiovascular patients. However, clinical guidelines on this drug combination are divergent. Therefore, we performed a systematic review to evaluate the effect of statin initiation on coagulation among VKA users. Methods: Following the PRISMA guidelines, we applied two broad search strategies for the drug interaction between VKA and statins in both Embase and Pubmed; 8623 unique hits were obtained. In the final sample, eight studies were included. Results: The most frequently used VKA in the studies was warfarin, while simvastatin was the most commonly initiated statin. All included studies showed a minor increase in the anticoagulant effect of VKA following statin initiation during VKA treatment. The reported increases in mean international normalized ratio (INR) ranged from 0.15–0.65. Conclusion: The anticoagulant effect of statin initiation in patients treated with VKA is likely to be of limited clinical relevance but should be evaluated individually.

AB - Purpose: Concomitant use of vitamin K antagonists (VKA) and statins is frequent in cardiovascular patients. However, clinical guidelines on this drug combination are divergent. Therefore, we performed a systematic review to evaluate the effect of statin initiation on coagulation among VKA users. Methods: Following the PRISMA guidelines, we applied two broad search strategies for the drug interaction between VKA and statins in both Embase and Pubmed; 8623 unique hits were obtained. In the final sample, eight studies were included. Results: The most frequently used VKA in the studies was warfarin, while simvastatin was the most commonly initiated statin. All included studies showed a minor increase in the anticoagulant effect of VKA following statin initiation during VKA treatment. The reported increases in mean international normalized ratio (INR) ranged from 0.15–0.65. Conclusion: The anticoagulant effect of statin initiation in patients treated with VKA is likely to be of limited clinical relevance but should be evaluated individually.

KW - Anticoagulants

KW - Drug interactions

KW - Statins

KW - Vitamin K antagonists

KW - Warfarin

U2 - 10.1007/s00228-020-03074-w

DO - 10.1007/s00228-020-03074-w

M3 - Review

C2 - 33895864

AN - SCOPUS:85105358360

VL - 77

SP - 1435

EP - 1441

JO - European Journal of Clinical Pharmacology

JF - European Journal of Clinical Pharmacology

SN - 0031-6970

ER -