title: Potential drug interaction between simvastatin and danazol causing rhabdomyolysis.
abstract: Rhabdomyolysis is a life-threatening clinical and biochemical syndrome that results from injury to skeletal muscle. Hydroxymethylglutaryl coenzyme A reductase inhibitors (statins) have been associated with myopathy and rhabdomyolysis. Although rhabdomyolysis is a rare adverse event associated with this class of drugs, their prevalent use in the management of dyslipidemia makes it increasingly important for clinicians to understand the nature of this condition. Rhabdomyolysis can occur with all statins when used alone and particularly when combined with other drugs that are themselves myotoxic or that elevate the concentration of the statin. Statins are particularly susceptible to the latter effect because of their metabolism by the CYP450 system and their low oral bioavailability. In this report, we describe a case of rhabdomyolysis and acute renal failure secondary to the interaction between danazol and simvastatin.
authors.affiliation: Department of Medicine, London Health Sciences Centre, Ontario.
authors.forename: E Roseann
authors.initials: ER
authors.lastname: Andreou
authors.forename: Séadna
authors.initials: S
authors.lastname: Ledger
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced; D000368:Aged; D000744:Anemia, Hemolytic, Autoimmune / Q000188:drug therapy; D051544:Cytochrome P-450 CYP3A; D003577:Cytochrome P-450 Enzyme System / Q000378:metabolism; D003613:Danazol / Q000009:adverse effects* / Q000378:metabolism; D004347:Drug Interactions; D004965:Estrogen Antagonists / Q000009:adverse effects* / Q000378:metabolism; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects* / Q000378:metabolism; D008297:Male; D006435:Renal Dialysis; D012206:Rhabdomyolysis / Q000139:chemically induced*; D019821:Simvastatin / Q000009:adverse effects* / Q000378:metabolism
chemical_list: D004965:Estrogen Antagonists; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D003577:Cytochrome P-450 Enzyme System; D019821:Simvastatin; C104464:CYP3A protein, human; D051544:Cytochrome P-450 CYP3A; D003613:Danazol