Rhabdomyolysis associated with simvastatin-nefazodone therapy.
Simvastatin is a hydroxymethyl glutaryl coenzyme A reductase inhibitor commonly used to treat patients with hyperlipidemia. It is a safe and effective medication in most patients when used appropriately. A serious side effect known as rhabdomyolysis may rarely occur in patients who take simvastatin, especially at higher doses and with agents that interact and increase the level of simvastatin in the blood. We describe the case of a patient with rhabdomyolysis that occurred after the patient's simvastatin was titrated to 80 mg at approximately the same time that his antidepressant medication was switched to nefazodone. We found only two other similar cases in the literature, both of which were presented as letters to the editor in two different journals. We present this case to add to the literature and to assist practitioners by raising their awareness of this interaction so that it can be monitored.
Department of Pharmacy Practice, School of Pharmacy and Health Professions, Creighton University Medical Center, Omaha, NE 68178, USA. mskrabal@creighton.edu
Maryann Z
MZ
Skrabal
Julie A
JA
Stading
Michael S
MS
Monaghan
D018687:Antidepressive Agents, Second-Generation / Q000009:adverse effects*; D003866:Depressive Disorder / Q000188:drug therapy; D004347:Drug Interactions; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects*; D006949:Hyperlipidemias / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D010879:Piperazines; D012206:Rhabdomyolysis / Q000139:chemically induced*; D019821:Simvastatin / Q000009:adverse effects*; D014230:Triazoles / Q000009:adverse effects* / Q000627:therapeutic use
D018687:Antidepressive Agents, Second-Generation; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D010879:Piperazines; D014230:Triazoles; C051752:nefazodone; D019821:Simvastatin