Prolonged inadvertent pravastatin use in pregnancy

Teelucksingh, S; Youssef, Julia; Sohan, Karen; Ramsewak, Samuel

doi:10.1016/j.reprotox.2003.11.003

Cited by 12 publications

(9 citation statements)

References 7 publications

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“…4 Pravastatin is one of the HMG-CoA reducatese inhibitors thus it decreases the synthesis of cholesterol and its derivatives that are important for normal fetal growth and development. To date, data obtained from experimental animals 5,6 and limited data from humans 7,8 suggest that pravastatin does not increase the risk of major congenital anomalies. 9 However, the use of other HMG-CoA reductase inhibitors (simvastatin, lovastatin, atorvastatin, cerivastatin) may be associated with an increase in the incidence of skeletal malformations 10 and was attributed to the difference in physicochemical properties between the hydrophilic pravastatin versus the other lipophilic HMG-CoA reductase inhibitors.…”

Section: Introductionmentioning

confidence: 99%

Transplacental transfer and distribution of pravastatin

Nanovskaya

Patrikeeva

Paul

et al. 2013

American Journal of Obstetrics and Gynecology

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Objectives Determine the bidirectional transfer of pravastatin across the dually perfused term human placental lobule and its distribution between the tissue, maternal and fetal circuits. Study design The transfer of pravastatin was determined in the Maternal-to-Fetal (n=11) and Fetal-to-Maternal (n=10) directions. Pravastatin was co-perfused with its [3H]-isotope and the marker compound antipyrine (20 μg/mL) and its [14C]-isotope. The concentration of pravastatin in the perfused tissue, the maternal and fetal circuits was determined using liquid scintillation spectrometry. Inside-out vesicles prepared from placental brush border membranes were utilized to investigate the role of efflux transporters in transplacental transfer of pravastatin. Results Pravastatin was transferred from the maternal to the fetal circuit and vise versa. In the Maternal-to-Fetal direction, the distribution of pravastatin at the end of experiment was as follows: 14 ± 5% of the drug was retained by the tissue, 68 ± 5% remained in the maternal circuit, and 18±4% was transferred to the fetal circuit. The normalized transfer of pravastatin (Clearance index) to antipyrine in the Fetal-to-Maternal direction (0.48 ± 0.07) was higher than its transfer in the Maternal-to-Fetal direction (0.36 ± 0.07, p<0.01). Furthermore, pravastatin inhibited the ATP-dependent uptake of the paclitaxel and estrone sulfate. Conclusions The transfer of pravastatin across the dually perfused placental lobule suggests that fetal exposure to pravastatin is plausible. The higher transfer of pravastatin in the Fetal-to-Maternal direction than the reverse as well as its inhibition of the ATP-dependent uptake of [3H]-paclitaxel and [3H]-estrone sulfate strongly suggest the involvement of efflux transporters in decreasing its transfer across the placenta, and support pravastatin favorable pharmacokinetic profile in pregnancy.

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Section: Introductionmentioning

confidence: 99%

Transplacental transfer and distribution of pravastatin

Nanovskaya

Patrikeeva

Paul

et al. 2013

American Journal of Obstetrics and Gynecology

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“…Five studies were performed on pregnant women with hypercholesterolemia 22,[25][26][27][28] and three studies were performed on women who had preeclampsia or were at high risk for it 24,29,30 . According to the methodology, the studies included nine cohort articles 16,22,23,25,28,[31][32][33][34] , six case reports 26,27,30,[35][36][37] , six case series 29,[38][39][40][41][42] , one clinical trial 24 , and one population-based case-referent study 43 . The studies were published from 1992 to 2018.…”

Section: Characteristics Of Studiesmentioning

confidence: 99%

Fetal toxicity associated with statins: A systematic review and meta-analysis

et al. 2021

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“…Twelve primary studies reported the rates of foetal malformations in women exposed to statins [13 && , [14][15][16][17][18][19][20][21][22][23][24]. Four were cohort studies [13 && , [14][15][16], one was a case-control study [17], three were case series [18][19][20] and four were case reports [21][22][23][24].…”

Section: Primary Studies On Safety Of Statins In Pregnancymentioning

confidence: 99%

“…Four were cohort studies [13 && , [14][15][16], one was a case-control study [17], three were case series [18][19][20] and four were case reports [21][22][23][24]. Seven studies evaluated the foetal outcomes after exposure to various statins such as atorvastatin [ 15,18,20].…”

Section: Primary Studies On Safety Of Statins In Pregnancymentioning

confidence: 99%