title: [Rhabdomyolysis in patients treated with simvastatin and cyclosporin: role of the hepatic cytochrome P450 enzyme system activity].
abstract: We describe two patients treated with a combination of cyclosporin and simvastatin who had to be hospitalized due to rhabdomyolysis. As suggested by reduced cyclosporin clearance, both patients had impaired activity of the hepatic cytochrome P450 enzyme system, which may have contributed to the development of rhabdomyolysis. After cessation of treatment with simvastatin and intensive hydration, both patients recovered within one week. While rhabdomyolysis has been described in several patients receiving the combination lovastatin/cyclosporin, so far only one case has been reported in patients treated with simvastatin/cyclosporin. Our cases therefore suggest that this complication may be more frequent than previously suspected. In patients treated with cyclosporin, HMG-CoA reductase inhibitors should be used cautiously, and concomitant administration of drugs inhibiting the hepatic cytochrome P450 enzyme system should be avoided.
authors.affiliation: Abteilung Klinische Pharmakologie, Universitätsspital Zürich.
authors.forename: C
authors.initials: C
authors.lastname: Meier
authors.forename: C
authors.initials: C
authors.lastname: Stey
authors.forename: T
authors.initials: T
authors.lastname: Brack
authors.forename: M
authors.initials: M
authors.lastname: Maggiorini
authors.forename: B
authors.initials: B
authors.lastname: Risti
authors.forename: S
authors.initials: S
authors.lastname: Krähenbühl
mesh_terms: D000924:Anticholesteremic Agents / Q000009:adverse effects*; D016572:Cyclosporine / Q000009:adverse effects* / Q000627:therapeutic use; D065607:Cytochrome P-450 Enzyme Inhibitors; D016027:Heart Transplantation; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D006937:Hypercholesterolemia / Q000188:drug therapy; D008099:Liver / Q000201:enzymology; D008148:Lovastatin / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012206:Rhabdomyolysis / Q000139:chemically induced* / Q000175:diagnosis / Q000201:enzymology; D019821:Simvastatin
chemical_list: D000924:Anticholesteremic Agents; D065607:Cytochrome P-450 Enzyme Inhibitors; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D016572:Cyclosporine; D008148:Lovastatin; D019821:Simvastatin
vernacular_title: Rhabdomyolyse bei mit Simvastatin und Ciclosporin behandelten Patienten: Rolle der Aktivität des Cytochrom-P450-Enzymsystems der Leber.