title: Rhabdomyolysis and acute renal failure due to combination therapy with simvastatin and warfarin.
abstract: Simvastatin, an inhibitor of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase, is widely used to treat hyperlipidaemia. Although myalgias are recognized adverse effects, clinically significant elevations in serum creatine phosphokinase (CPK) levels are uncommon. We describe a case of rhabdomyolysis and acute renal failure associated with concomitant use of simvastatin and warfarin. Rhabdomyolysis and renal failure occurred 7 days after warfarin (5 mg day-1) was added to a chronic stable dose of simvastatin (20 mg day-1) and resolved abruptly after discontinuation of simvastatin. We recommend careful monitoring when warfarin is given to patients receiving simvastatin.
authors.affiliation: Department of Medicine, Medical College of Virginia/Virginia Commonwealth University, Richmond, Virginia, USA. amogyoro@hsc.vcu.edu
authors.forename: A
authors.initials: A
authors.lastname: Mogyorósi
authors.forename: B
authors.initials: B
authors.lastname: Bradley
authors.forename: A
authors.initials: A
authors.lastname: Showalter
authors.forename: M L
authors.initials: ML
authors.lastname: Schubert
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood / Q000139:chemically induced*; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use; D003402:Creatine Kinase / Q000097:blood; D004347:Drug Interactions; D006801:Humans; D006903:Hydroxymethylglutaryl CoA Reductases / Q000009:adverse effects*; D008297:Male; D012206:Rhabdomyolysis / Q000097:blood / Q000139:chemically induced*; D019821:Simvastatin / Q000009:adverse effects*; D014859:Warfarin / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D014859:Warfarin; D019821:Simvastatin; D006903:Hydroxymethylglutaryl CoA Reductases; D003402:Creatine Kinase