Practice Question for Statin/Gemfibrozil Interaction

[RX8]

I've been seeing A LOT of patients that are on a statin as well as gemfibrozil. In school I always was taught to have the gemfibrozil changed to another agent, or to never combine the two due to an increased risk of myopathy.

In the real world, how many of you see this interaction and do nothing? I have such a strong impulse to call the doctor to suggest a change but other pharmacists I've talked to said that it wasn't necessary.

I just wanted to get some thoughts out there from some of you, thanks!

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[lorain]

i see it all the time

i dont call, i counsel the pt

 

[Old Timer]

Depends on the dose. The dose of the statin has to be a max of simvastatin 20 mg or it's equivalent..... Higher doses get the call & the recommendation....

 

[Thoughtfulsinner]

i see it all the time

i dont call, i counsel the pt

This unless the patient has kidney problems, then I'd contact the practitioner.

 

[Jbuprepharm]

happens everyday, and if you call to verify they're like "uh yeah, he needs it" as if you're stupid and couldn't possibly understand why they be prescribed together.

Educate the patient, tell them what to look for. (and yes, in school I also learned that you never ever ever do them together, but as you'll find out, school is full of shat)

 

[meister]

"Be sure to look for any destruction of your skeletal muscle. Yes, if you wake up one morning and have lost one of your biceps muscles you should probably call your doctor."

 

[MustLoveDrugs]

Depends on the dose. The dose of the statin has to be a max of simvastatin 20 mg or it's equivalent..... Higher doses get the call & the recommendation....

Agreed. Of note, fluvastatin does not require a dosage adjustment but all the other statins do.

 

[RX8]

Good to know, thanks guys. I've seen it time after time and it always pops up as a "major" interaction which gives me more pause for concern than normal.

 

[J ROD]

It is dose dependent and person dependent. Look at it but usually move on.