Table 3. Associations between statins, in patients dispensed drugs with or without a pronounced inhibitory effect on their metabolism.

Statins	Groups ofdispensedstatin dose1	Interactivedrugs n (%)	Comparator drugsn (%)	OddsInteractive drugs(vs. Comparatordrugs)	Odds ratiosUnadjusted(95% CI2)	p-values	Odds ratios -adjusted forage, gender, andmedical setting(95% CI2)	p-values
		erythromycin	doxycycline
		(n = 576)	(n = 16199)
CYP3A4 3	High dose	76 (13)	2157 (13)	0.035	0.85 (0.60–1.20)	0.35	0.87 (0.60–1.25)	0.44
interacting statins:
simvastatin/
atorvastatin
	Low dose	444 (77)	12697 (78)	0.035	0.84 (0.63–1.12)	0.23	0.92 (0.69–1.23)	0.56
Comparator		56 (10)	1345 (8)	0.042
statins: pravastatin/
fluvastatin/
rosuvastatin
(reference group)
		verapamil/	amlodipine/
		diltiazem	felodipine
		(n = 9246)	(n = 176168)
CYP3A4 3 interacting	High dose	1183 (13)	24130 (14)	0.046	0.59 (0.54–0.65)	<0.001	0.62 (0.56–0.68)	<0.001
statins: simvastatin/
atorvastatin
	Low dose	7262 (79)	142334 (81)	0.051	0.62 (0.57–0.67)	<0.001	0.63 (0.58–0.68)	<0.001
Comparator statins:		801 (9)	9704 (6)	0.083
pravastatin /
fluvastatin /
rosuvastatin
(reference group)
		gemfibrozil	fenofibrate/
		(n = 3712)	bezafibrate
			(n = 4275)
Pharmacokinetic	High dose	326 (9)	514 (12)	0.63	0.63 (0.54–0.73)	<0.001	0.65 (0.55–0.76)	<0.001
interaction with
gemfibrozil: any statin
	Low dose	966 (26)	1351 (32)	0.72	0.71 (0.64–0.79)	<0.001	0.70 (0.63–0.78)	<0.001
no statin		2420 (65)	2410 (56)	1.00
(reference group)

Data are based on drug dispensing in individuals ≥18 years of age (n = 7 554 680), 15 August to 15 December, 2011.

¹High statin doses were defined as 40 mg or more for atorvastatin, fluvastatin, pravastatin.

and simvastatin and 20 mg or more for rosuvastatin.

²Confidence Intervals.

³Cytochrome P450 enzyme (CYP) 3A4.