Updated Interaction Advice for Simvastatin

The Medicines and Healthcare products Regulatory Agency (MHRA) has written to healthcare professionals with updated advice about drug interactions between medications containing simvastatin (Zocor, Inegy) and other drugs that may be prescribed at the same time.

Simvastatin is a drug taken to reduce cholesterol and is something that Birdshotters may be taking to counteract a side effect of their medication for Birdshot.

It states that:- “Simvastatin can cause muscle weakness (myopathy) or muscle breakdown leading to kidney damage (rhabdomyolysis) and it was already known that at high doses and if certain other medicines are taken at the same time this risk is increased.”

Of particular note are two drugs which a few our of our members also take are in the list of medicines not be taken at the same time as simvastatin.

They are the immunosuppressant known as Cyclosporine/ciclosporin (Neoral, Sandimmune)

and Amlodine which is  common blood pressure medication.    In this instance it recommends that simvastatin should not be used at a dose of more than 20mg daily

As with cyclosporine it is also important to note that grapefruit juice should be avoided by anyone taking simvastatin.

What does this mean to Birdshotters?

If any of our members are worried about this you  should talk to your doctor or health care professional  about it, rather than just stop taking the medication, because the benefits of treatment with simvastatin continue to outweigh the risks for most people who are on them.

To read the whole alert follow the link below.

http://uk.mediguard.org/alerts/alert/2164.html

New Study Links Bisphosphonates to Vision Problems Risk

We have posted before about oral bisphosphonates (including Fosamax) and emerging evidence that first-time use of these is associated with a greater risk of developing two inflammatory diseases: uveitis and scleritis.

We have also posted on the risks of bisphosphonates in relation to atypical femur fractures.

The article highlights both these risks and can be found at:

http://www.prweb.com/releases/2012/9/prweb9883870.htm

The important thing to remember is that you need advice about your drug regime and the interactions of each of your medications, as well as the potential benefits and risks, so you can make an informed decision.  The risks highlighted in this article may be outweighed by the benefits in individual case – only you and your consultant can decide between you.

We, with Birdshot, who take high doses of steroids need to protect our bones.  So, becoming informed about our condition, our medication regimes, interactions and risks and benefits is really important.

Bisphosphonates (Alendronic Acid) and possible side effects

We have written quite a few articles about bisphosphonates (we, with Birdshot are usually prescribed bisphosphonates, such as alendronic acid, when we are on steroids).  Bisphosphonates help to protect us against the damage to our bones that steroids may produce.

A recent study from British Columbia looked retrospectively at people who were first-time users of oral bisphosphonates and who had visited an ophthalmologist between 2000 and 2007.  This group was compared to people who did not use oral bisphosphonates.

The study concluded that the incidence of uveitis in first-time users of oral bisphosphonates was slightly higher than for non-users and the incidence of scleritis was quite a lot higher in first-time bisphosphonates users.

The findings were that people using oral bisphosphonates for the first time may be at higher risk of scleritis and uveitis than non-bisphosphonate users.

This is not really new information – we have known this for some time. It is important always to keep a check on our medications and side effects, and to have strong relationships with our consultants so we can fully understand the risks versus the benefits of each medication.

The full article can be found at

http://www.ncbi.nlm.nih.gov/pubmed/22470169?dopt=Citation

Drug side effects and interaction

We know that drug interaction and side effects are a worry to a lot of our members. In our search to find information we came across a couple of useful sites. The first is a US based health site that includes clear patient information for both vitamins and supplements as well as medications.

http://www.nlm.nih.gov/medlineplus/druginformation.html

Following on from the post about alternative medications and whether peppermint might have an adverse effect when taking cyclosporine, we were very interested to see that it clearly states on this site that it does.

The second website is run by Mediguard. The interesting thing about this site is you can develop your own profile and list all the medications you currently take. You give a few bits of information about yourself like age, etc. and it will give you a risk rating and tell you which medications interact with other medications that you are taking. This is very handy for people with Birdshot who may find that for the first time in their lives they are on a range of medications. The service also will send you updates on new information that comes out about the drugs you are taking, safety notices etc. A recent email asked us to tell our friends and family about this useful service so we thought we would pass it on.

http://uk.mediguard.org/referral