Heart disease patients should inform their healthcare providers of all drugs they’re taking to manage interactions with cholesterol-lowering medicine, a new American Heart Association statement recommends.

“Healthcare providers and their patients who take statins need to be aware that these medications could interact with their other heart disease medications, such as those to control blood pressure and treat abnormal heart rhythms,” said Barbara S. Wiggins, Pharm.D., chair of the writing committee of the statement published in the American Heart Association journal Circulation.

“While many of these drug combinations are safe, every patient is different and will tolerate medications differently. Patients need to be aware that interactions can occur and should speak to their healthcare providers about any unusual side effects or concerns.”

Drug interactions occur when medications are combined and enhance or decrease the effect of one or both drugs. An estimated 2.8 percent of all hospital admissions are attributed to drug interactions, but the number could be higher because medication-related issues are often reported as adverse drug reactions and underlying conditions such as thyroid disease or rheumatologic disease may disguise drug interactions.

Statins are prescribed to patients with hardening of the arteries, or atherosclerosis, and those at high risk for developing it.

The writing committee examined combinations of these drugs for potential interactions:

  • Antiarrhythmic drugs to treat abnormal heart rhythms
  • Medications to treat congestive heart failure
  • Antiplatelet agents and anticoagulants to thin the blood
  • Immunosuppressive agents for patients who have undergone a heart transplantation
  • Non-statin cholesterol-lowering agents
  • Calcium channel blockers to treat high blood pressure

They also highlighted changes needed in the labeling of some statin drugs since they were initially placed on the market.

The statement identifies specific doses at which certain heart disease medications can be used safely with statins as well as the combinations of statins and cardiac medications that may be potentially harmful.

Patients and healthcare providers should identify and review all medications at each visit and during transitions of care so that drug interactions can be identified early, evaluated and managed appropriately by adjusting dosage, changing to a safer statin or discontinuing the interacting medication, said Wiggins, a clinical pharmacy specialist in cardiology at the Medical University of South Carolina in Charleston.