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Rigshospitalet - a part of Copenhagen University Hospital
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Drug-drug interaction between warfarin and statins: A Danish cohort study

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  • Anna E Engell
  • Andreas L O Svendsen
  • Bent S Lind
  • Christen L Andersen
  • John S Andersen
  • Tora G Willadsen
  • Frederik Persson
  • Anton Pottegård
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Initiation of statin treatment is suggested to increase the international normalised ratio (INR) among warfarin users. However, available data is limited and conflicting. We conducted a register-based cohort study to evaluate the drug-drug interaction between warfarin and statins. By linking data on INR measurements and filled prescriptions, we identified warfarin users 2000-2015 initiating simvastatin (n=1,363), atorvastatin (n=165), or rosuvastatin (n=23). Simvastatin initiation led to an increase in mean INR from 2.40 to 2.71, with INRs peaking after 4 weeks, corresponding to a mean change of 0.32 (95%CI 0.25-0.38). High-dose and low-dose simvastatin led to comparable changes (mean change 0.33 vs 0.29). Initiation of atorvastatin and rosuvastatin lead to INR increases of 0.27 (95%CI 0.12-0.42) and 0.30 (95%CI -0.09-0.69). In conclusion, initiation of simvastatin, atorvastatin, or rosuvastatin among warfarin users led to a minor increase in INR. The magnitude of this change is for most patients likely of limited clinical relevance.

Original languageEnglish
Article number14428
JournalBritish Journal of Clinical Pharmacology
Volume87
Issue number2
Pages (from-to)694-699
Number of pages6
ISSN0306-5251
DOIs
Publication statusPublished - Feb 2021

Bibliographical note

© 2020 The British Pharmacological Society.

    Research areas

  • anticoagulants and warfarin, drug interactions, statins

ID: 60052930