Key result
Co-administration of valsartan and simvastatin increased the AUC of valsartan, simvastatin beta-hydroxy acid, and simvastatin by 14%, 19%, and 23%, respectively, lacking clinical relevance.
Why the study?
Does co-administration of valsartan and simvastatin alter their pharmacokinetics in healthy subjects?
RCT (n=18)
Open-label
Crossover
Does co-administration of valsartan and simvastatin alter their pharmacokinetics in healthy subjects?
Co-administration of valsartan and simvastatin results in minor pharmacokinetic changes that are unlikely to be clinically relevant.
Supports unrestricted co-administration without dose adjustment; reinforces minimal pharmacokinetic interaction between valsartan and simvastatin.
OBJECTIVE: The potential for a pharmacokinetic drug interaction between valsartan, an antihypertensive drug, and simvastatin, a lipid-lowering agent, was investigated in this study. This was an open-label, multiple-dose, randomized, three-period, cross over study in 18 healthy subjects. Each subject received one 160 mg valsartan tablet or one 40 mg simvastatin tablet or co-administration of valsartan (160 mg) and simvastatin (40 mg) tablets for 7 days, with a 7-day inter-dose washout period. The steady-state pharmacokinetics of valsartan, simvastatin beta-hydroxy acid (active metabolite of simvastatin) and simvastatin (pro-drug) were determined on day 7 of each dosing period. RESULTS: The results were interpreted based on the point estimates and the 90% confidence intervals. These results indicated that the area under the curve of plasma concentration from 0 to 24 hours (AUC(0-24)) of valsartan, simvastatin beta-hydroxy acid and simvastatin was increased by 14%, 19%, and 23%, respectively, with the combination treatment. In addition, the maximum concentration (C(max)) of valsartan and simvastatin beta-hydroxy acid was increased by 10% and 22%, respectively, and the C(max) of simvastatin was decreased by 26% with the combination treatment. All treatments were safe and well tolerated. CONCLUSIONS: Based on the wide therapeutic dosage ranges of valsartan and simvastatin, and the highly variable pharmacokinetics of three analytes, the observed differences in the exposure and C(max) of valsartan, simvastatin beta-hydroxy acid and simvastatin in the combination treatment are unlikely to be of clinical relevance.
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Sunkara et al. (2007) conducted an RCT in Healthy (n=18). Valsartan and simvastatin co-administration vs. Valsartan 160 mg alone or simvastatin 40 mg alone was evaluated on Steady-state pharmacokinetics (AUC(0-24) and C(max)) of valsartan, simvastatin beta-hydroxy acid, and simvastatin. Co-administration of valsartan and simvastatin increased the AUC of valsartan, simvastatin beta-hydroxy acid, and simvastatin by 14%, 19%, and 23%, respectively, lacking clinical relevance.
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