title: [Myotoxicity and rhabdomyolisis due to statins].
abstract: Rhabdomyolysis is a rare but potentially fatal complication associated with the use of cholesterol synthesis inhibitors (statins). The complication can develop in susceptible patients and with the concomitant use of medications that impede the biodegradation of statins, for example, biotransformation via the cytochrome P450 system. This may result in the plasma and tissue concentrations of statins, and their active metabolites, increasing to levels that are toxic for striated muscle. Myopathy is present when plasma activity levels of creatinine kinase are raised to in excess of 10 times the upper limit of the normal value. Muscular complaints which may be indicative of myotoxicity and subsequent myopathy are present in 1-7% of statin users. Albeit to varying degrees, all statins can induce myotoxicity especially at high dosages. Rhabdomyolysis was clearly more prevalent under cerivastatin users than the users of other statins and was therefore recently withdrawn from the market. Statins should be withdrawn immediately if myopathy is suspected. Prompt withdrawal may prevent rhabdomyolysis.
authors.affiliation: Universitair Medisch Centrum Utrecht, afd. Interne Geneeskunde, Postbus 85.500, 3508 GA Utrecht. j.d.banga@azu.nl
authors.forename: J D
authors.initials: JD
authors.lastname: Banga
mesh_terms: D003402:Creatine Kinase / Q000097:blood*; D051544:Cytochrome P-450 CYP3A; D003577:Cytochrome P-450 Enzyme System / Q000187:drug effects* / Q000378:metabolism; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D004335:Drug and Narcotic Control; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects*; D006949:Hyperlipidemias / Q000188:drug therapy; D006899:Mixed Function Oxygenases / Q000187:drug effects* / Q000378:metabolism; D009135:Muscular Diseases / Q000139:chemically induced* / Q000201:enzymology; D009426:Netherlands; D011725:Pyridines / Q000009:adverse effects; D012206:Rhabdomyolysis / Q000139:chemically induced* / Q000201:enzymology
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011725:Pyridines; D003577:Cytochrome P-450 Enzyme System; C086276:cerivastatin; D006899:Mixed Function Oxygenases; C104464:CYP3A protein, human; D051544:Cytochrome P-450 CYP3A; D003402:Creatine Kinase
vernacular_title: Myotoxiciteit en rhabdomyolysis ten gevolge van statinen.