Analysis of Statin Drug Interactions for Dyslipidemia in In-patients at Royal Prima Hospital in 2022 -2024

Minaraya Naiborhu; Daimah Wirdatus Sanaun Harahap; Novitaria Br Sembiring

doi:10.55606/ijhs.v6i1.6916

Authors

Minaraya Naiborhu Universitas Prima Indonesia
Daimah Wirdatus Sanaun Harahap Universitas Prima Indonesia
Novitaria Br Sembiring Universitas Prima Indonesia

DOI:

https://doi.org/10.55606/ijhs.v6i1.6916

Keywords:

Drug Interactions, Dyslipidemia, Pharmacodynamics, Pharmacokinetics, Statins

Abstract

Dyslipidemia is a metabolic disorder characterized by abnormal lipid profiles, including elevated levels of low-density lipoprotein (LDL) cholesterol and triglycerides, or reduced high-density lipoprotein (HDL), which increase the risk of cardiovascular diseases. Statins are the primary lipid-lowering agents used to manage dyslipidemia; however, their concomitant use with other medications may result in clinically sig-nificant drug interactions that can compromise therapeutic outcomes and patient safety. This study aimed to analyze the types and severity of drug interactions involving statins in hospitalized dyslipidemia patients at Royal Prima Hospital Medan in 2022-2024. A non-experimental, retrospective study design was em-ployed through a review of patient medical records. Data were analyzed descriptively using Stockley’s Drug Interactions and Drugs.com to identify potential interactions and classify them by mechanism and severity. A total of 156 drug interaction cases were identified, comprising 131 moderate (83.98%), 24 major (15.38%), and 1 minor (0.64%) interaction. The most frequent interactions were observed between atorvastatin and amlodipine (39.69%), followed by atorvastatin and clopidogrel (27.49%). Most interac-tions were pharmacokinetic in nature, primarily associated with CYP3A4 enzyme inhibition. In conclu-sion, moderate drug interactions were the most prevalent among statin users, emphasizing the critical role of clinical pharmacists in monitoring andmanaging combination therapies to enhance the safety and ef-fectiveness of dyslipidemia treatment.

Downloads

Download data is not yet available.

References

Ballena, J. C., Zuzunaga-Montoya, F. E., Loayza-Castro, J. A., Vásquez-Romero, L. E. M., Tapia-Limonch, R., Carrillo, C. I. G. de, & Vera-Ponce, V. J. (2025). Global prevalence of dyslipidemias in the general adult population: A systematic review and meta-analysis. Journal of Health, Population and Nutrition, 3. https://doi.org/10.1186/s41043-025-01054-3

Bhattarai, A. K., Acharya, A., & Karki, P. K. (2020). Use of statins as lipid-lowering agents in hypercholesterolemia in a tertiary care hospital: A descriptive cross-sectional study. Journal of Nepal Medical Association, 58(232), 1031–1035. https://doi.org/10.31729/jnma.5444

Dalal, J., Chandra, P., Chawla, R., Kumar, V., Abdullakutty, J., & Natarajan, V. (2024). Clinical and demographic characteristics of patients with coexistent hypertension, type 2 diabetes mellitus, and dyslipidemia: A retrospective study from India. Drugs - Real World Outcomes, 11(1), 167–176. https://doi.org/10.1007/s40801-023-00400-3

Engell, A. E., Svendsen, A. L. O., Andersen, C. L., Andersen, J. S., Persson, F., Pottegård, A., Lind, B. S., & Willadsen, T. G. (2021). Drug–drug interaction between warfarin and statins: A Danish cohort study. British Journal of Clinical Pharmacology, 87(2), 694–699. https://doi.org/10.1111/bcp.14428

Frechen, S., Solodenko, J., Wendl, T., Dallmann, A., Ince, I., Lehr, T., Lippert, J., & Burghaus, R. (2021). A generic framework for the physiologically based pharmacokinetic platform qualification of PK-Sim and its application to predicting cytochrome P450 3A4-mediated drug–drug interactions. CPT: Pharmacometrics & Systems Pharmacology, 10(6), 633–644. https://doi.org/10.1002/psp4.12636

Gharaibeh, L., Al Zoubi, S., Sartawi, H., & Ayyad, D. (2023). The appropriateness of the use of statins for the secondary and primary prevention of atherosclerotic cardiovascular disease: A cross-sectional study from Jordan. [Journal name not provided], 5480–5492.

Grundy, S. M., Vega, G. L., & Wong, N. D. (2023). Is there a role for coronary calcium in patients with diabetes? The American Journal of Cardiology, 190, 98–101. https://doi.org/10.1016/j.amjcard.2022.12.003

Kim, J. H., Song, J. H., Kim, M. Y., Hong, J. H., Sunwoo, J., & Jung, J. G. (2024). Pharmacokinetic comparison of a fixed-dose combination of candesartan cilexetil/amlodipine/atorvastatin versus co-administration of individual formulations in healthy participants. Advances in Therapy, 41(7), 2808–2825. https://doi.org/10.1007/s12325-024-02869-y

Kim, J., Ko, J., & Kim, J. (2020). Pharmacokinetic and safety profiles of a fixed-dose combination of amlodipine, valsartan, and atorvastatin: A 3-period replicate crossover study. Clinical Pharmacology in Drug Development, 9, 1–10. https://doi.org/10.1002/cpdd.727

Lin, X., Dai, L., Zhou, Y., Yu, Z., Zhang, W., Shi, J., Cao, D., Zeng, L., Chen, H., Song, B., & Yu, P. S. (2023). Comprehensive evaluation of deep and graph learning on drug–drug interactions prediction. Briefings in Bioinformatics. https://doi.org/10.1093/bib/bbad235

Mach, F., Baigent, C., Catapano, A. L., Casula, M., Badimon, L., Chapman, M. J., De Backer, G. G., Delgado, V., Ference, B. A., Graham, I. M., Halliday, A., & Landmesser, U. (2020). 2019 ESC/EAS guidelines for the management of dyslipidaemias: Lipid modification to reduce cardiovascular risk. European Heart Journal, 41(1), 111–188. https://doi.org/10.1093/eurheartj/ehz455

Mar'athus, S. P. S., Faizah, A. K., & Damayanti, A. (2022). Journal of Pharmacy Science and Technology, 3(2), 65–69.

Mustikaningtias, I., Maharani, L., & Pratiwi, H. (2020). Profil kadar kolesterol darah pasien dislipidemia terkait waktu minum obat di faskes primer Purwokerto. Acta Pharmaceutica Indonesia, 8(2), 80–88. https://doi.org/10.20884/1.api.2020.8.2.2432

Nazar, A. D., Lipoeto, N. I., Fahmida, U., & Rita, R. S. (2024). Relationship of body fat distribution and anthropometric status with lipid profiles in ethnic Minang adult women. The Open Public Health Journal, 17(1), 1–7. https://doi.org/10.2174/0118749445353029241030111530

Ningrum, D. M., Ramdaniah, P., & Permana, D. A. S. H. (2023). Indonesian Journal of Pharmacy and Natural Product, 6(1), 24–29. https://doi.org/10.35473/ijpnp.v6i01.2202

Park, I., Hong, S., Kim, S. Y., & Hwang, J. (2024). Reduced side effects and improved pain management by continuous ketorolac infusion with patient-controlled fentanyl injection compared with single fentanyl administration in pelviscopic gynecologic surgery: A randomized, double-blind, controlled study. Korean Journal of Anesthesiology, 77(1), 77–84. https://doi.org/10.4097/kja.23217

Patel, K. A., Bhatt, M. H., Hirani, R. V., Patel, V. A., Patel, V. N., Shah, G. B., & Chorawala, M. R. (2022). Assessment of potential drug–drug interactions among outpatients in a tertiary care hospital: Focusing on the role of P-glycoprotein and CYP3A4 (retrospective observational study). Heliyon, 8(11), e11278. https://doi.org/10.1016/j.heliyon.2022.e11278

Patramurti, C., & Virginia, D. M. (2025). Smoking as a risk factor for dyslipidemia: Study among type 2 diabetes mellitus patients in a private hospital in Yogyakarta. Jurnal Ilmu Kefarmasian Indonesia, 23(2), 314–324. https://doi.org/10.35814/jifi.v23i2.1720

Piszczatoski, C. R., & Smith, S. M. (2022). Pharmacological considerations when treating hypertensive patients for osteoarthritis. Expert Opinion on Pharmacotherapy, 23(15), 1673–1676. https://doi.org/10.1080/14656566.2022.2133601

Rosada, A., Kassner, U., Weidemann, F., König, M., Buchmann, N., Steinhagen-Thiessen, E., & Spira, D. (2020). Hyperlipidemias in elderly patients: Results from the Berlin Aging Study II (BASE-II), a cross-sectional study. Lipids in Health and Disease, 19(1), 1–10. https://doi.org/10.1186/s12944-020-01277-9

Schetz, D., Anand, J. S., Ku, K., Wirtwein, M., & Koci, I. (2025). COVID-19 vaccination protects skeletal muscle against statin-related side effects. Vaccines, 13(4), 357. https://doi.org/10.3390/vaccines13040357

Schmelzer, K. P., Liebetrau, D., Kämmerer, W., Meisinger, C., & Hyhlik-Dürr, A. (2023). Strategies for avoiding typical drug–drug interactions and drug-related problems in patients with vascular diseases. Medicina, 59(4), 780. https://doi.org/10.3390/medicina59040780

Seredynska, N. M., Kornienko, V. I., Kibkalo, D. V., Suvorova, O. S., Marchenko, O. M., & Ladogubets, O. V. (2020). Amlodipine modulation of analgesic effect of non-steroidal anti-inflammatory drugs in rheumatoid arthritis comorbid with arterial hypertension. Regulatory Mechanisms in Biosystems, 11(4), 557–562. https://doi.org/10.15421/022086

Streja, E. P., Dian, A. S., & MD, FRCPC, FACP, FACE. (2020). Management of dyslipidemia in the elderly. Endotext. https://doi.org/10.34883/PI.2020.12.5.011

Whitlock, R., Leon, S. J., Manacsa, H., Askin, N., Rigatto, C., Fatoba, S. T., Farag, Y. M. K., & Tangri, N. (2023). The association between dual RAAS inhibition and risk of acute kidney injury and hyperkalemia in patients with diabetic kidney disease: A systematic review and meta-analysis. Nephrology Dialysis Transplantation, 38(6), 2503–2516. https://doi.org/10.1093/ndt/gfad101

Wirdatus, D., Harahap, S., Andrajati, R., Sari, S. P., & Handayani, D. (2024). Medication adherence among drug-resistant tuberculosis (DR-TB) patients at Universitas Indonesia Hospital. Jurnal Respirologi Indonesia, 44(3). https://doi.org/10.36497/jri.v44i3.775

Wu, Q., He, C., Huang, W., Song, C., & Hao, X. (2024). Gastroesophageal reflux disease influences blood pressure components, lipid profile and cardiovascular diseases: Evidence from a Mendelian randomization study. Journal of Translational Internal Medicine, 12(5). https://doi.org/10.1515/jtim-2024-0017

Ziółkowski, M., Ratajczak, J., Obońska, K., Adamski, P., Banach, M., Chlebus, K., Grymuza, M., Grzelakowska, K., Jankowski, P., & Konarski, J. (2025). Lipid profile and the variables associated with control of selected lipid parameters in patients of a large multi-specialist hospital in Poland: The Jurasz Lipid Study (JLS). Lipids in Health and Disease, 24, 1–5. https://doi.org/10.1186/s12944-025-02712-5