Lovastatin-induced rhabdomyolysis possibly associated with clarithromycin and azithromycin.
OBJECTIVE
To describe two cases of rhabdomyolysis in patients taking lovastatin that were precipitated by the use of the newer macrolide antibiotics clarithromycin and azithromycin.


METHODS
In each case, the patients were treated over 5 years with lovastatin and developed rhabdomyolysis that coincided with the completion of a prescribed regimen of a newer macrolide antibiotic. Following intravenous hydration and administration of bicarbonate, the patients' condition resolved without permanent' sequelae.


CONCLUSIONS
Rhabdomyolysis is a clinical syndrome resulting from the destruction of skeletal muscle that may progress to renal failure Several drugs have been associated with rhabdomyolysis, including lovastatin, a hydroxymethylglutaryl-coenzyme A reductase inhibitor. Erythromycin is a macrolide antibiotic that may increase the risk of lovastatin-induced rhabdomyolysis. To our knowledge, these cases are the first published reports of lovastatin-induced rhabdomyolysis associated with azithromycin and clarithromycin.


CONCLUSIONS
The risk of drug-induced rhabdomyolysis due to the potential interaction between lovastatin and azithromycin or clarithromycin should be considered before the concomitant use of these agents.
Grunden
J W
JW
Clinical Pharmacy, College of Pharmacy, Ferris State University.
Fisher
K A
KA
D000368:Aged; D000900:Anti-Bacterial Agents / Q000378:metabolism / Q000627:therapeutic use*; D000924:Anticholesteremic Agents / Q000009:adverse effects* / Q000378:metabolism; D017963:Azithromycin / Q000378:metabolism / Q000627:therapeutic use*; D017291:Clarithromycin / Q000378:metabolism / Q000627:therapeutic use*; D004347:Drug Interactions; D005260:Female; D006801:Humans; D008148:Lovastatin / Q000009:adverse effects* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000188:drug therapy; D012206:Rhabdomyolysis / Q000139:chemically induced*; D012852:Sinusitis / Q000188:drug therapy
D000900:Anti-Bacterial Agents; D000924:Anticholesteremic Agents; D017963:Azithromycin; D008148:Lovastatin; D017291:Clarithromycin