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Pharmacokinetic DDIs result in altered absorption, distribution, metabolism, or excretion of a medication. When statin-fibrate combination therapy is indicated, fenofibrate or fenofibric acid is preferred because of a reduced incidence of DDIs compared with the gemfibrozil-statin combination. There are circumstances in which gemfibrozil may be the only available fibrate, cost may be a consideration, or fenofibrate may not be tolerated. Under any circumstance, the use of gemfibrozil should be avoided in combination with lovastatin, pravastatin, and simvastatin. Pharmacokinetic data suggest a minor increase in statin exposure with coadministration of amlodipine and lovastatin or simvastatin, and combination therapy may be considered. There is no evidence of significant interaction when amlodipine is coadministered with atorvastatin, pitavastatin, rosuvastatin, fluvastatin, and pravastatin, and combination therapy may be considered. Caution should be exercised with statin-calcium channel blocker combination therapy in patients of various ethnic backgrounds, particularly those of Asian descent.

Verapamil is used alone or together with other medicines to treat heart rhythm problems, severe chest pain angina, or high blood pressure hypertension. High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. High blood pressure may also increase the risk of heart attacks. These problems may be less likely to occur if blood pressure is controlled. Verapamil is a calcium channel blocker.

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Context: Oridonin has been traditionally used in Chinese treatment of various cancers, but its poor bioavailability limits its therapeutic uses. Verapamil can enhance the absorption of some drugs with poor oral bioavailability. Whether verapamil can enhance the bioavailability of oridonin is still unclear. Objective: This study investigated the effect of verapamil on the pharmacokinetics of oridonin in rats and clarified its main mechanism. The effects of verapamil on the transport and metabolic stability of oridonin were also investigated using Caco-2 cell transwell model and rat liver microsomes.

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Over several decades, the intensity eg, number and doses of antihypertensive drug therapy has been recognized as being more important for preventing cardiovascular disease than the choice of which specific drug to use initially. In addition, although selected antihypertensive drug classes are more beneficial than others in patients with certain comorbidities, the clinical benefit of antihypertensive drug therapy in the majority of patients is linked to the magnitude of blood pressure lowering, rather than the choice of drug. Details of lifestyle interventions to lower blood pressure are presented separately. In addition to nonpharmacologic therapy, some patients should be initiated on antihypertensive drug therapy. Our recommendations regarding indications for drug therapy are discussed elsewhere.

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