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The Effect of Converting from Pravastatin to Simvastatin on the Pharmacodynamics of Warfarin
Author(s) -
Lin Jennifer C.,
Ito Matthew K.,
Stolley Stephen N.,
Morreale Anthony P.,
Marcus David B.
Publication year - 1999
Publication title -
the journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.92
H-Index - 116
eISSN - 1552-4604
pISSN - 0091-2700
DOI - 10.1177/00912709922007598
Subject(s) - warfarin , simvastatin , pravastatin , medicine , pharmacodynamics , pharmacology , pharmacokinetics , atrial fibrillation , cholesterol
Forty‐six adult patients maintained on warfarin therapy were converted from pravastatin to simvastatin. Mean international normalized ratio (INR) significantly increased from 2.42 to 2.74 , p = 0.002. Although warfarin doses were reduced in 7 patients and increased in 4 patients following the postconversion INR measurements, the pre‐ and postconversion median weekly warfarin dose of all 46 patients did not differ significantly. The number of patients with an INR > 3.0 increased significantly from 6 to 16 following the conversion. There was no report of unusual episodes of bleeding. The results indicate that antihyperlipidemic therapy can be changed safely from pravastatin to simvastatin in patients who are taking warfarin concomitantly. Additional anticoagulation monitoring is not necessary in institutions where patients are followed in formal anticoagulation clinics .