Effects of vitamin D supplementation in atorvastatin-treated patients: a new drug interaction with an unexpected consequence

Clin Pharmacol Ther. 2009 Feb;85(2):198-203. doi: 10.1038/clpt.2008.165. Epub 2008 Aug 27.

Abstract

The objective of this study was to determine vitamin D supplementation effects on concentrations of atorvastatin and cholesterol in patients. Sixteen patients (8 men, 8 women; 10 Caucasians, 4 African Americans, 1 Hispanic, 1 Asian), aged 63 +/- 11 years (mean +/- SD, weight 92 +/- 31 kg) on atorvastatin (45 +/- 33 mg/day) were studied with and without supplemental vitamin D (800 IU/day for 6 weeks). Levels of vitamin D (1,25-dihydroxy(OH) and 25 OH-metabolites), atorvastatin (parent, OH-acid metabolites, lactone, and lactone metabolites), and cholesterol (total, low-density lipoprotein (LDL) cholesterol, and high-density lipoprotein (HDL) cholesterol) were determined at 0.5, 3, and 10 h after dosing. Vitamin D supplementation increased vitamin D-25-OH metabolites (P < 0.0001) without increased 1,25-dihydroxy vitamin D. Atorvastatin and active metabolite concentrations (P < 0.001) as well as LDL-cholesterol and total-cholesterol levels (97 +/- 28 mg/dl vs. 83 +/- 30 and 169 +/- 35 mg/dl vs. 157 +/- 37, P < 0.005) were lower during vitamin D supplementation. The conclusion of the study is that vitamin D supplementation lowers atorvastatin and active metabolite concentrations yet has synergistic effects on cholesterol concentrations.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Atorvastatin
  • Cholesterol, LDL / blood
  • Cross-Over Studies
  • Dietary Supplements*
  • Drug Interactions / physiology
  • Drug Synergism
  • Female
  • Heptanoic Acids / blood*
  • Heptanoic Acids / therapeutic use
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Pyrroles / blood*
  • Pyrroles / therapeutic use
  • Vitamin D / blood*
  • Vitamin D / pharmacology

Substances

  • Cholesterol, LDL
  • Heptanoic Acids
  • Pyrroles
  • Vitamin D
  • Atorvastatin