Simvastatin interaction
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Interaction with concomitant erythromycin leading to rhabdomyolysis in an elderly patient: case report An 80-year-old man was admitted with a 1-week history of myalgia and an inability to walk. On examination, he had elevated levels of AST (2069 U/L) and creatine kinase (87 564 U/L), and myoglobinuria. Subsequently, he developed renal failure necessitating haemofiltration. His drug history included 4 weeks’ treatment with erythromycin while he was receiving concurrent simvastatin [dosages, therapeutic indications and time to reaction onset not stated]; it was concluded that his delayed-onset rhabdomyolysis was due to an interaction between these two drugs. He subsequently completely recovered [treatment not stated]. Author comment: "Statins are metabolised by the cytochrome p450 3A4 enzyme, and [such] interactions are thought to be due to the inhibition of this enzyme." Campbell G, et al. A cautionary tale: delayed onset rhabdomyolysis due to erythromycin/simvastatin interaction. Age and Ageing 36: 597, No. 5, Sep 2007 801096070 England
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Reactions 5 Jan 2008 No. 1183
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