Pharmacokinetic and pharmacodynamic assessments of HMG-CoA reductase inhibitors when coadministered with everolimus

J Clin Pharmacol. 2002 Feb;42(2):222-8. doi: 10.1177/00912700222011148.

Abstract

The authors assessed the mutual influence of the immunosuppressant everolimus (Certican) and the HMG-CoA reductase inhibitors atorvastatin and pravastatin when coadministered based on pharmacokinetic and pharmacodynamic measures. In this randomized, open-label, three-way crossover study, 24 healthy men received three single-dose oral treatments: 2 mg everolimus, 20 mg atorvastatin (n = 12) or 20 mg pravastatin (n = 12), and the respective statin coadministered with everolimus. Consecutive treatments were separated by a 14-day washout. The pharmacokinetics of all three drugs and total HMG-CoA reductase inhibitors were measured. Everolimus Cmax was reduced by 9% and 10% with atorvastatin and pravastatin coadministration; the corresponding decreases in everolimus AUC were 5% and 6%, respectively. Everolimus coadministration increased the Cmax of atorvastatin by 11% but had no influence on atorvastatin AUC. Coadministration of everolimus with pravastatin was associated with a 10% decrease in pravastatin Cmax and a 5% decrease in the AUC. The elimination half-lives of the two statins were unaffected by everolimus. Changes in total HMG-CoA reductase inhibitors in plasma exhibited generally similar patterns as for the parent statin exposures. Single-dose administrations of everolimus with either atorvastatin or pravastatin did not influence the pharmacokinetics of everolimus, atorvastatin, pravastatin, or total HMG-CoA reductase inhibitors in plasma to a clinically relevant extent.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Area Under Curve
  • Atorvastatin
  • Chromatography, High Pressure Liquid
  • Cross-Over Studies
  • Drug Interactions
  • Everolimus
  • Female
  • Half-Life
  • Heptanoic Acids / pharmacokinetics
  • Heptanoic Acids / pharmacology
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / adverse effects
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / pharmacokinetics*
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / pharmacology*
  • Immunosuppressive Agents / adverse effects
  • Immunosuppressive Agents / pharmacokinetics*
  • Immunosuppressive Agents / pharmacology*
  • Male
  • Mass Spectrometry
  • Middle Aged
  • Pravastatin / pharmacokinetics
  • Pravastatin / pharmacology
  • Pyrroles / pharmacokinetics
  • Pyrroles / pharmacology
  • Sirolimus / adverse effects
  • Sirolimus / analogs & derivatives
  • Sirolimus / pharmacokinetics*
  • Sirolimus / pharmacology*

Substances

  • Heptanoic Acids
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Immunosuppressive Agents
  • Pyrroles
  • Everolimus
  • Atorvastatin
  • Pravastatin
  • Sirolimus