Cholesterol Lowering Medications
Bile acid sequestrants
Chlolestyramine (Cholybar, Questran, Questran Light)
Colestipol (Colestid)
Fibric Acid Derivatives
Gemfibrozil (Lopid)
Statins
Atorvastatin (Lipitor)
Cerivastatin (Baycol)
Fluvastatin (Lescol)
Lovastatin (Mevacor)
Pravastatin (Pravachol)
Simvastatin (Zocor)
Nutritional Considerations:
Limit alcohol with all statins (except fluvastatin) and avoid with gemfibrozil. (Pronsky 1999)
The activity of statins and gemfibrozil may decrease coenzyme Q10 levels. Consult your pharmacist concerning supplementation. (Bargossi 1994) (Ghirlanda 1993) (Mortensen 1997).
Avoid grapefruit juice with all statins, except Pravastatin. Pravastatin does not seem to be affected by grapefruit juice. (Lilja 1999) (Kantola 1998) (Pronsky 1999)
Do not take statins with niacin due to possible muscle weakness and wasting. (Pronsky 1999)
Supplementation of fat soluble vitamins, (A, D, E and K) vitamin B-12 and folic acid may be necessary with long term use of bile acid sequestrants. (Facts and Comparisons 2000) (Brinker 1998)
Iron and zinc absorption may also be impaired with bile acid sequestrants. Consult your pharmacist regarding possible supplementation. (Brinker 1998) (Pronsky 1999)
Fiber will reduce absorption of lovastatin and gemfibrozil. If taken, it should be separated from the drugs by several hours. (Pronsky 1999) (Richter 1991)
Herbal Considerations:
Alfalfa, artichoke, black cohosh, fenugreek, garlic, ginger, plantain, skullcap, and tansy lower blood fat levels and theoretically, may have an additive effect if used with antihyperlipidemic drugs. Avoid these herbs with the above drugs. (Newall 1996)
References
Bargossi Am, Grossi G, Fiorella PL, et al: Exogenous CoQ10 supplementation prevents plasma ubiquinone reduction induced by HMG-CoA reductase inhibitors, Mol Aspects Med, 1994, 15 (suppl): 187-93
Brinker, Francis N.D. Herb Contraindications and Drug Interactions. Eclectic Medical Publications. 1998.
Facts and Comparisons, Clinisphere 2.0. A Wolters Kluwer Company. 2000.
Ghirlanda, G et al., Evidence of plasma "CoQ10"-lowering effect by HMG-CoA reductase inhibitors. J of Clin. Pharm. 1993, 33(3):226-229.
Kantola T, Kivisto KT, Neuvonen PJ. Grapefruit juice greatly increases serum concentrations of lovastatin and lovastatin acid. Clin Pharmacol Ther 1998;63:396-402.
Lilja JJ, Kivisto KT, Neuvonen PJ. Grapefruit juice increases serum concentrations of atorvastatin and has no effect on pravastatin. Clin Pharmacol Ther 1999; 66:118-27.
Mortensen SA, Leth A, Agner E, Rohde M. Dose-related decrease of serum coenzyme Q10 during treatment with HMG-CoA reductase inhibitors. Mol Aspects Med 1997;18(suppl):S137-44.
Newall CA, Anderson LA, Phillipson JD. Herbal Medicines A Guide for Health-care Professionals. London: The Pharmaceutical Press, 1996.
Pronsky, Zaneta M. Food Medication Interactions. 11th edition. 1999
Richter W, Jacob B, Schwandt P. Interaction between fiber and lovastatin. Lancet 1991;338:706 [letter].
| Signup Free Applied Health Journal |
||||
|
FREE Sample Issue Your email address is all we need to start you on a better path to health. We respect your privacy.
|
