Statins are widely prescribed medicines and are also available in fixed dose combinations
with other drugs to treat several chronic ailments. Given the safety issues associated
with statins it may be important to assess feasibility of a single time concentration
strategy for prediction of exposure (area under the curve; AUC). The peak concentration
(Cmax) was used to establish relationship with AUC separately for pravastatin and simvastatin
using published pharmacokinetic data. The regression equations generated for statins
were used to predict the AUC values from various literature references. The fold difference
of the observed divided by predicted values along with correlation coefficient (r)
were used to judge the feasibility of the single time point approach. Both pravastatin
and simvastatin showed excellent correlation of Cmax vs. AUC values with r value≥0.9638 (p<0.001). The fold difference was within 0.5-fold
to 2-fold for 220 out of 227 AUC predictions and >81% of the predicted values were
in a narrower range of >0.75-fold but <1.5-fold difference. Predicted vs. observed
AUC values showed excellent correlation for pravastatin (r=0.9708, n=115; p<0.001)
and simvastatin (r=0.9810; n=117; p<0.001) suggesting the utility of Cmax for AUC predictions. On the basis of the present work, it is feasible to develop
a single concentration time point strategy that coincides with Cmax occurrence for both pravastatin and simvastatin from a therapeutic drug monitoring
perspective.
Key words
pravastatin - simvastatin - pharmacokinetics - peak concentration - AUC - correlation
- limited sampling strategy - therapeutic drug monitoring - statins