{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T20:01:51Z","timestamp":1770321711208,"version":"3.49.0"},"reference-count":31,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2012,1,12]],"date-time":"2012-01-12T00:00:00Z","timestamp":1326326400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2012,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>The co\u2010administration of cytochrome P450 3A4 (CYP3A4) inhibitors with simvastatin or atorvastatin (CYP3A4\u2010metabolised statins) is associated with increased statin exposure and can increase the risk of adverse drug reactions. The aim of this study was to measure the concomitant exposure of patients to CYP3A4\u2010metabolised statins and CYP3A4 inhibitors in the UK primary care population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The co\u2010administration of statins and CYP3A4 inhibitors during 2008 was examined in the General Practice Research Database, a large nationally representative UK primary care database. All known inhibitors were included with labelled inhibitors identified using the Medicines and Healthcare products Regulatory Agency Drug Safety Update and UK summary of product characteristics for statins. Exposure was examined in patients overall, patients 65\u2009years and older and those prescribed higher doses of statins.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 364\u2009574 patients included in the analyses. Ninety\u2010three percent of the patients were prescribed CYP3A4\u2010metabolised statins, most whom received simvastatin (72%) and atorvastatin (24%). Approximately one third (30%) of the patients prescribed a CYP3A4\u2010metabolised statin had also been prescribed a concomitant CYP3A4 inhibitor during the study period, including 11% prescribed a concomitant labelled inhibitor, with an annualised median days of concomitant use of 173\u2009days, predominantly involving macrolide antibiotics and calcium channel blockers co\u2010prescriptions. Rates were higher in the subgroup aged 65 and over and in those on high dose statins.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The co\u2010prescription of CYP3A4\u2010metabolised statins and CYP3A4 inhibitors is common in UK primary care. This co\u2010prescription suggests the limited appreciation of potential interactions and Medicines and Healthcare products Regulatory Agency safety advice, with the potential to increase likelihood for side effects amongst patients. Strategies to reduce drug interactions with potential adverse effects should be targeted at prescribers and pharmacists. Copyright \u00a9 2012 John Wiley &amp; Sons, Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pds.2308","type":"journal-article","created":{"date-parts":[[2012,1,12]],"date-time":"2012-01-12T06:54:00Z","timestamp":1326351240000},"page":"485-493","source":"Crossref","is-referenced-by-count":30,"title":["Co\u2010administration of statins with cytochrome P450 3A4 inhibitors in a UK primary care population"],"prefix":"10.1002","volume":"21","author":[{"given":"Ameet","family":"Bakhai","sequence":"first","affiliation":[{"name":"Barnet General Hospital  Wellhouse Lane Barnet London UK"},{"name":"AMORE Health Ltd  Pinner London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Una","family":"Rigney","sequence":"additional","affiliation":[{"name":"AstraZeneca UK  Luton Bedfordshire UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel","family":"Hollis","sequence":"additional","affiliation":[{"name":"AstraZeneca UK  Luton Bedfordshire UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cathy","family":"Emmas","sequence":"additional","affiliation":[{"name":"AstraZeneca UK  Luton Bedfordshire UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2012,1,12]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2005.12.007"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1345\/aph.10228"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2005.12.011"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.2165\/00002018-200629110-00005"},{"key":"e_1_2_8_6_1","unstructured":"CG67 Lipid modification: NICE guideline (full). 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