[Rhabdomyolysis following the coprescription of atorvastatin and fusidic acid]

Rev Med Interne. 2013 Jan;34(1):39-41. doi: 10.1016/j.revmed.2012.09.006. Epub 2012 Oct 24.
[Article in French]

Abstract

Introduction: The incidence of rhabdomyolysis associated with statin therapy is underestimated, especially when they are coprescribed with other drugs.

Case report: We report a 68-year-old man who presented with rhabdomyolysis causing muscle weakness that occurred seven months after fusidic acid was coprescribed with atorvastatin. A literature review identified eight additional cases of rhabdomyolysis with fusidic acid and atorvastatin and six with fusidic acid and simvastatin. The risk of rhabdomyolysis associated with statin therapy is dependent of the extent to which an individual statin is metabolized by P450 3A4 isoenzyme and to the degree of inhibition of this isoenzyme activity by some antimicrobial.

Conclusion: Our case report highlights the importance of the close monitoring of patients on statins, especially when new drugs are started or if patients become symptomatic, with testing for occurrence of muscle weakness and creatine kinase serum level.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / adverse effects*
  • Atorvastatin
  • Creatine Kinase / blood
  • Fusidic Acid / administration & dosage
  • Fusidic Acid / adverse effects*
  • Heptanoic Acids / administration & dosage
  • Heptanoic Acids / adverse effects*
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / administration & dosage
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / adverse effects*
  • Male
  • Muscle Weakness / chemically induced
  • Prosthesis-Related Infections / drug therapy
  • Pyrroles / administration & dosage
  • Pyrroles / adverse effects*
  • Rhabdomyolysis / blood
  • Rhabdomyolysis / chemically induced*
  • Staphylococcal Infections / drug therapy

Substances

  • Anti-Bacterial Agents
  • Heptanoic Acids
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Pyrroles
  • Fusidic Acid
  • Atorvastatin
  • Creatine Kinase