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Clopidogrel-Statin Interaction

Nawarskas, James J. PharmD

Cardiology in Review:
Curbside Consult
Abstract

There has been recent concern regarding the potential for certain HMG CoA reductase inhibitors (statins) to interfere with the activation of clopidogrel, thereby leaving patients susceptible to thrombotic events. Ex vivo studies have both supported and refuted an interaction, likely a result of heterogeneity in study design and methodology. More recent reports have been more consistent in demonstrating no increase in thrombotic event rates (myocardial infarction, stroke, etc) in patients receiving clopidogrel with a statin compared with clopidogrel alone, although these reports have all been retrospective in nature. Until a prospective study shows detriment when clopidogrel and statins are given together compared with either drug being administered alone, the debate regarding whether this interaction is of practical importance will continue. Until then, the weight of the evidence does not currently support a change in prescribing patterns for the sole purpose of avoiding a potential statin-clopidogrel interaction.

Author Information

From the University of New Mexico, College of Pharmacy, Albuquerque, NM.

Reprints: James J. Nawarskas, PharmD, University of New Mexico, College of Pharmacy, MSC09 5360, 1 University of New Mexico, Albuquerque, NM 87131-0001. E-mail: nawarska@unm.edu

© 2004 Lippincott Williams & Wilkins, Inc.