Cerivastatin and gemfibrozil-associated rhabdomyolysis.
OBJECTIVE
To report a case of rhabdomyolysis resulting from concurrent use of cerivastatin and gemfibrozil. CASE SUMMARY An 82-year-old white man presented to the emergency department with severe muscle weakness and inability to walk approximately one month after starting cerivastatin. He had been taking gemfibrozil for several years without any known adverse effects. Both medications were discontinued and the patient recovered. He was discharged with a diagnosis of rhabdomyolysis secondary to his medications.


CONCLUSIONS
Four previous reports describing rhabdomyolysis in patients on concomitant cerivastatin and gemfibrozil have been cited. Although monotherapy with cerivastatin is well tolerated and has a low frequency of adverse events, the combination with nicotinic acid (i.e., niacin) or a fibric-acid derivative (i.e., gemfibrozil, fenofibrate) may result in severe skeletal muscle toxicity and rhabdomyolysis.


CONCLUSIONS
According to the Naranjo scale, a probable relationship exists between the concomitant use of gemfibrozil and cerivastatin with the resulting development of rhabdomyolysis. Concurrent use of gemfibrozil and cerivastatin is therefore contraindicated.
Bruno-Joyce
J
J
Pharmacy Department, Wentworth-Douglass Hospital, Dover, NH 03820-3535, USA. rxjb@wdhospital.com
Dugas
J M
JM
MacCausland
O E
OE
D000368:Aged; D000369:Aged, 80 and over; D003402:Creatine Kinase / Q000097:blood; D004347:Drug Interactions; D015248:Gemfibrozil / Q000009:adverse effects*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects*; D000960:Hypolipidemic Agents / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011725:Pyridines / Q000009:adverse effects*; D012206:Rhabdomyolysis / Q000097:blood / Q000139:chemically induced* / Q000503:physiopathology
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000960:Hypolipidemic Agents; D011725:Pyridines; C086276:cerivastatin; D003402:Creatine Kinase; D015248:Gemfibrozil