THE ISSUES OF DRUG INTERACTION IN COMBINATION PHARMACOTHERAPY IN CARDIOLOGICAL PRACTICE

Abstract

Background. The objective of this study was to analyze the frequency and structure of appointment of undesirable
combinations of statins with other drugs. We have taken into account their interactions at the level of metabolism CYP3A
isoenzymes of cytochrome P450 and transportation of proteins-transporters P-glycoprotein and ОАТР1В to identify
significant and potentially dangerous drug combinations.
Materials and methods. The study included medical records of people with diagnosis: Coronary heart disease with
concomitant hypercholesterolemia, confirmed by laboratory methods. In total, we analyzed 2790 outpatients. The prevalence
and structure of drug interactions at 14 medical institutions of Semey city (Kazakhstan) were studied
(pharmacoepidemiological, cross-sectional study).
Results. Our study revealed the presence of significant and potentially dangerous interactions of statins with other drugs
from the cardiovascular group in the majority of patients (62%). In cases where it is recommended to prescribe combinations
of drugs for clinical indications with caution and under the control of biochemical and other indicators, we found no evidence
of this control in 72.5% of cases.
Conclusion. We have determined a fairly high frequency of the prescription of undesirable combinations of statins with
other drugs from the cardiovascular group, having a competitive metabolism at the level of CYP3A, OATP1B1 and Pglycoprotein in absolute terms and compared with the data of studies conducted in developed countries.