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Amoxicillin/simvastatin Nausea and myalgia: case report A man [age at the time of reaction onset not clearly stated] developed myalgia during treatment with simvastatin for hyperlipidaemia, and nausea during treatment amoxicillin [not all indications stated]. The man, at the age of 66 years, was hospitalised with ongoing swelling in the legs, forearms, and periorbital area along with decreased appetite and poor oral intake. His medical history was significant for various conditions including hyperlipidaemia. Upon admission, it was noted that he had been reviving various medications including amoxicillin and simvastatin [routes and dosages not stated]. However, he developed amoxicillin-associated nausea and simvastatinassociated myalgia [durations of treatments to reaction onsets and outcomes not stated]. Following extensive examinations, he was diagnosed with hemophagocytic lymphohistiocytosis. He received dexamethasone and ruxolitinib. Subsequently, he was also diagnosed with primary cutaneous gamma–delta Tcell lymphoma, for which he received chemotherapy with cyclophosphamide, doxorubicin, dexamethasone and brentuximab vedotin. Eventually, he died due to large intraparenchymal haemorrhage, as well as transtentorial and tonsillar herniation. Author comment: "[T]reatment with amoxicillin caused nausea, and treatment with simvastatin caused myalgia." Maus MV, et al. Case 35-2019: A 66-year-old man with pancytopenia and rash. New England Journal of Medicine 381: 1951-1960, No. 20, 14 Nov 2019. Available from: URL: http://doi.org/10.1056/NEJMcpc1909627 803440268 USA

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Reactions 21 Dec 2019 No. 1784