Flavonoid-statins interactions

Background: Statins and dietary modifications are the cornerstone of hypercholesterolemia management. Even if flavonoids could play a role in the prevention of hypercholesterolemia, the question whether there is a helpful or dangerous association between flavonoid-rich foods and statins has remained unanswered for a long time1. Therefore, although it is known that 58% of the more serious side effects of statins is related to interactions with other drugs and occurs especially when using statins metabolized at the level of cytochrome P450 (CYP)2, the aim of our work is to analyse the potential interaction between flavonoid-rich foods and statins in terms of musculoskeletal symptoms, on the basis of the type of statin metabolism. Methods: Subjects that use statins metabolised by CYP3A4 (N=20), CYP2C9 (N=20), statins minimally or not metabolised by CYP (N=20), and healthy control subjects (N=20) have been recruited. Data have been collected through questionnaires and a 7-day food diary, in order to evaluate the characteristics (pathologies, body mass index, etc.), the eating habits of the subjects, the adherence to the Mediterranean diet and the presence of musculoskeletal disorders. Results: The Mediterranean diet-statins interaction recently documented3 could be particularly accentuated for statins metabolised by CYP. Conclusions: eating habits should be considered not only during drug therapy but also during the use of nutraceuticals. [1] ISSN: 1875-5453. 2015. 16(9):833-46. [2] ISSN: 1972-6481. 2016. 17(6):447-55. [3] ISSN: 1874-1754. 2019. 276:248-254