Skip to main content
SpringerLink
Log in

Early detection of drug interactions utilizing a computerized drug prescription handling system—focus on cerivastatin–gemfibrozil

  • Pharmacoepidemiology and Prescription
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

Objectives

Based on the recent cerivastatin experience, we retrospectively evaluated the effect of notifying a drug alert utilizing a computerized drug-handling system.

Methods

The evaluation was carried out during three periods: period I corresponded to all prescriptions issued during April, 2001 (“baseline period”), before the Spanish Drug Agency issued alerts on the concomitant therapy with cerivastatin and gemfibrozil; period II (June) corresponded to a time in which a first informative note had been released; and period III (July) after the second warning alert was issued.

Results

Data collected included the reading of 2,693,656 drug prescriptions, 1,937,083 (71.9%) of which contained patient information. Forty-four patients received combined therapy with cerivastatin and gemfibrozil over the three periods, yielding 55 exposures: 27 during the baseline period, and 28 between periods II and III, when the alert bulletins had already been released. Moreover, 41.6% of doctors included in the follow-up repeated the hazardous prescription during those two periods.

Conclusions

The effect of the informative notes about the risk of prescribing cerivastatin and gemfibrozil concomitantly on doctors’ prescribing habits was limited. The system for screening information from drug prescriptions presented herein allows the early detection of drug interactions by identifying the doctors who issue hazardous prescriptions as well as patients at the highest risk of adverse drug reactions, thus allowing a personal feedback with both of them.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Seymour RM, Routledge PA (1998) Important drug–drug interactions in the elderly. Drugs Aging 12:485–494

    CAS  PubMed  Google Scholar 

  2. Hamilton RA, Briceland LL, Andritz MH (1998) Frequency of hospitalization after exposure to known drug–drug interactions in a Medicaid population. Pharmacotherapy 18:1112–1120

    CAS  PubMed  Google Scholar 

  3. Heerey A, Barry M, Ryan M, Kelly A (2000) The potential for drug interactions with statin therapy in Ireland. Ir J Med Sci 169:176–179

    CAS  PubMed  Google Scholar 

  4. Bates DW, Teich JM, Lee J, Seger D, Kuperman GJ, Ma’Luf N, Boyle D, Leape L (1999) The impact of computerized physician order entry on medication error prevention. J Am Med Inform Assoc 6:313–321

    CAS  PubMed  Google Scholar 

  5. Leape LL, Brennan TA, Laird N, Lawthers AG, Localio AR, Barnes BA, Hebert L, Newhouse JP, Weiler PC, Hiatt H (1991) The nature of adverse events in hospitalized patients. Results of the Harvard Medical Practice Study II. N Engl J Med 324:377–384

    CAS  PubMed  Google Scholar 

  6. Bates DW, Cullen DJ, Laird N, Petersen LA, Small SD, Servi D, Laffel G, Sweitzer BJ, Shea BF, Hallisey R et al (1995) Incidence of adverse drug events and potential adverse drug events. Implications for prevention. ADE Prevention Study Group. JAMA 274:29–34

    CAS  PubMed  Google Scholar 

  7. Rosholm JU, Bjerrum L, Hallas J, Worm J, Gram LF (1998) Polypharmacy and the risk of drug–drug interactions among Danish elderly. A prescription database study. Dan Med Bull 45:210–213

    CAS  PubMed  Google Scholar 

  8. Boberg M, Angerbauer R, Fey P, Kanhai WK, Karl W, Kern A, Ploschke J, Radtke M (1997) Metabolism of cerivastatin by human liver microsomes in vitro. Characterization of primary metabolic pathways and of cytochrome P450 isozymes involved. Drug Metab Dispos 25:321–331

    CAS  PubMed  Google Scholar 

  9. Wang JS, Neuvonen M, Wen X, Backman JT, Neuvonen PJ (2002) Gemfibrozil inhibits CYP2C8-mediated cerivastatin metabolism in human liver microsomes. Drug Metab Dispos 30:1352–1356

    Article  PubMed  Google Scholar 

  10. Farmer JA (2001) Learning from the cerivastatin experience. Lancet 358:1383–1385

    Article  CAS  PubMed  Google Scholar 

  11. Backman JT, Kyrklund C, Neuvonen M, Neuvonen PJ (2002) Gemfibrozil greatly increases plasma concentrations of cerivastatin. Clin Pharmacol Ther 72:685–691

    Article  CAS  PubMed  Google Scholar 

  12. Martin J, Krum H (2003) Cytochrome P450 drug interactions within the HMG-CoA reductase inhibitor class: are they clinically relevant? Drug Saf 26:13–21

    CAS  PubMed  Google Scholar 

  13. Alexandridis G, Pappas GA, Elisaf MS (2000) Rhabdomyolysis due to combination therapy with cerivastatin and gemfibrozil. Am J Med 109:261–262

    Article  CAS  PubMed  Google Scholar 

  14. Bruno-Joyce J, Dugas JM, MacCausland OE (2001) Cerivastatin and gemfibrozil-associated rhabdomyolysis. Ann Pharmacother 35:1016–1019

    Article  CAS  PubMed  Google Scholar 

  15. Mastroianni CM, d’Ettorre G, Forcina G, Lichtner M, Corpolongo A, Coletta S, Vullo V (2001) Rhabdomyolysis after cerivastatin-gemfibrozil therapy in an HIV- infected patient with protease inhibitor-related hyperlipidemia. Aids 15:820–821

    Article  CAS  PubMed  Google Scholar 

  16. Thompson CA (2001) Cerivastatin withdrawn from market. Am J Health Syst Pharm 58:1685

    CAS  Google Scholar 

  17. Wooltorton E (2001) Bayer pulls cerivastatin (Baycol) from market. CMAJ 165:632

    CAS  PubMed  Google Scholar 

  18. Schiff GD, Keehr LM, Sai TT, Bult J (2002) High rates of adverse effects and patient unawareness of withdrawn lipid-lowering drug combination in a public hospital clinic. Pharmacoepidemiol Drug Saf 11:643–645

    Article  PubMed  Google Scholar 

  19. Gandhi TK, Burstin HR, Cook EF, Puopolo AL, Haas JS, Brennan TA, Bates DW (2000) Drug complications in outpatients. J Gen Intern Med 15:149–154

    Article  CAS  PubMed  Google Scholar 

  20. Petty BG (2000) Identifying and reducing complications of outpatient medications. J Gen Intern Med 15:207–208

    Article  CAS  PubMed  Google Scholar 

  21. Halkin H, Katzir I, Kurman I, Jan J, Malkin BB (2001) Preventing drug interactions by online prescription screening in community pharmacies and medical practices. Clin Pharmacol Ther 69:260–265

    Article  CAS  PubMed  Google Scholar 

  22. Hamilton-Craig I (2001) Statin-associated myopathy. Med J Aust 175:486–489

    CAS  PubMed  Google Scholar 

  23. Guyton JR, Dujovne CA, Illingworth DR (1999) Dual hepatic metabolism of cerivastatin—clarifications. Am J Cardiol 84:497

    CAS  Google Scholar 

  24. Shek A, Ferrill MJ (2001) Statin-fibrate combination therapy. Ann Pharmacother 35:908–917

    Google Scholar 

  25. Garcia-Valdecasas-Campelo E, Gonzalez-Reimers E, Lopez-Lirola A, Rodriguez-Rodriguez E, Santolaria-Fernandez F (2001) Acute rhabdomyolysis associated with cerivastatin therapy. Arch Intern Med 161:893

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

Presented in part as an abstract at the ASCPT meeting 2002. Supported by grants 00/0034/01 from Fondo de Investigacion Sanitaria, Instituto de Salud Carlos III, Ministerio de Sanidad y Consumo (Madrid, Spain), IPR00C054 from Junta de Extremadura (Mérida, Spain) and from Convenio de Farmacovigilancia, Consejeria de Sanidad (Junta de Extremadura, Mérida, Spain) and Universidad de Extremadura (Badajoz, Spain). This study was carried out in coordination with COST B15 from European Union.

Author information

Authors and Affiliations

  1. Drug Surveillance Center of Extremadura, Department of Pharmacology, Medical School, University of Extremadura, Avenida de Elvas, 06071 , Badajoz, Spain

    Tomás Morera, Guillermo Gervasini, Juan A. Carrillo & Julio Benitez

Authors
  1. Tomás Morera
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Guillermo Gervasini
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Juan A. Carrillo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Julio Benitez
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Julio Benitez.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Morera, T., Gervasini, G., Carrillo, J.A. et al. Early detection of drug interactions utilizing a computerized drug prescription handling system—focus on cerivastatin–gemfibrozil. Eur J Clin Pharmacol 59, 917–921 (2004). https://doi.org/10.1007/s00228-003-0711-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00228-003-0711-2

Keywords

Search

Navigation