Long-term effects of gastric bypass and duodenal switch on systemic exposure of atorvastatin.

Background: A previous study of 22 patients undergoing either gastric bypass or duodenal switch showed increased systemic exposure of atorvastatin acid 3-8 weeks after surgery in the majority of patients. This study aimed to investigate the long-term effects on systemic exposure of atorvastatin acid in the same group of patients.

Methods: An 8-h pharmacokinetic investigation was performed a median of 27 months (range 21-45 months) after surgery.

Statin induced myotoxicity: the lactone forms are more potent than the acid forms in human skeletal muscle cells in vitro.

Statins exist in both acid and lactone forms in vivo. High plasma levels of the lactone forms have been observed in patients with statin induced myopathy. In the present study, the hypothesis that lactone forms have a higher potency of inducing myotoxicity as compared to acid forms was investigated.