スタチン系薬剤の他剤との臨床および非臨床薬物動態学的相互作用の比較
緒言 医薬品の相互作用は臨床上重要であるが,開発段階ですべての薬物との相互作用について検討することは不可能なため,市販後に他剤との相互作用によって思わぬ副作用が発現する場合がある.薬物相互作用の評価には,臨床データが最も重要であることはいうまでもないが,現時点で臨床データが得られていない場合や相互作用機構の推定のためには非臨床データを活用することが必要となる.HMG-CoA還元酵素阻害剤(スタチン)はコレステロール生合成の律速酵素のHMG-CoA還元酵素を阻害し,血中のコレステロール濃度を減少させる薬剤である.スタチンによる重篤な毒性はまれに見られる横紋筋融解症で,時として死に至る.スタチンと...
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| Published in | 医療薬学 Vol. 33; no. 4; pp. 291 - 300 |
|---|---|
| Main Authors | , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人日本医療薬学会
2007
日本医療薬学会 |
| Online Access | Get full text |
| ISSN | 1346-342X 1882-1499 |
| DOI | 10.5649/jjphcs.33.291 |
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| Abstract | 緒言 医薬品の相互作用は臨床上重要であるが,開発段階ですべての薬物との相互作用について検討することは不可能なため,市販後に他剤との相互作用によって思わぬ副作用が発現する場合がある.薬物相互作用の評価には,臨床データが最も重要であることはいうまでもないが,現時点で臨床データが得られていない場合や相互作用機構の推定のためには非臨床データを活用することが必要となる.HMG-CoA還元酵素阻害剤(スタチン)はコレステロール生合成の律速酵素のHMG-CoA還元酵素を阻害し,血中のコレステロール濃度を減少させる薬剤である.スタチンによる重篤な毒性はまれに見られる横紋筋融解症で,時として死に至る.スタチンと他剤との併用により,この発現頻度が増加する場合のあることが知られており1),これはスタチンの血中濃度増加が主な原因の一つと考えられている.従来より,スタチンとgemfibrozilとの相互作用(スタチンの毒性発現頻度の増加)が問題となっていたが,特にcerivastatinとgemfibrozilとの併用により横紋筋融解症による死亡が多発したため,cerivastatinは市場から撤退した2). |
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| AbstractList | 緒言 医薬品の相互作用は臨床上重要であるが,開発段階ですべての薬物との相互作用について検討することは不可能なため,市販後に他剤との相互作用によって思わぬ副作用が発現する場合がある.薬物相互作用の評価には,臨床データが最も重要であることはいうまでもないが,現時点で臨床データが得られていない場合や相互作用機構の推定のためには非臨床データを活用することが必要となる.HMG-CoA還元酵素阻害剤(スタチン)はコレステロール生合成の律速酵素のHMG-CoA還元酵素を阻害し,血中のコレステロール濃度を減少させる薬剤である.スタチンによる重篤な毒性はまれに見られる横紋筋融解症で,時として死に至る.スタチンと他剤との併用により,この発現頻度が増加する場合のあることが知られており1),これはスタチンの血中濃度増加が主な原因の一つと考えられている.従来より,スタチンとgemfibrozilとの相互作用(スタチンの毒性発現頻度の増加)が問題となっていたが,特にcerivastatinとgemfibrozilとの併用により横紋筋融解症による死亡が多発したため,cerivastatinは市場から撤退した2). |
| Author | 齋藤, 充生 三宅, 真二 浦野, 勉 長谷川, 隆一 平田, 睦子 |
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| DOI | 10.5649/jjphcs.33.291 |
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| StartPage | 291 |
| Title | スタチン系薬剤の他剤との臨床および非臨床薬物動態学的相互作用の比較 |
| URI | https://www.jstage.jst.go.jp/article/jjphcs/33/4/33_4_291/_article/-char/ja http://mol.medicalonline.jp/en/journal/download?GoodsID=db5pharm/2007/003304/001&name=0291-0300j |
| Volume | 33 |
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| ispartofPNX | 医療薬学, 2007, Vol.33(4), pp.291-300 |
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