Rhabdomyolysis and renal failure associated with gemfibrozil monotherapy.
OBJECTIVE
To report a case of rhabdomyolysis and acute renal failure associated with gemfibrozil monotherapy of hyperlipidemia.


METHODS
A 30-year-old white man with hypertension, type 1 diabetes mellitus, and hyperlipidemia was hospitalized due to myalgias, nausea, and vomiting that began after he started working as a jackhammer operator 4 days previously. His medications were lisinopril, aspirin, insulin, and gemfibrozil. Creatine kinase and creatinine, which previously had been mildly elevated and normal, respectively, were markedly elevated, consistent with rhabdomyolysis with acute renal failure.


CONCLUSIONS
As of December 8, 2003, this is the only report of a patient with normal baseline creatinine level who developed rhabdomyolysis with acute renal failure associated with gemfibrozil monotherapy. Strenuous exertion, hypovolemia, and lisinopril use may have contributed to the severity of illness. An objective causality assessment revealed that an adverse drug reaction to gemfibrozil was possible.


CONCLUSIONS
Gemfibrozil monotherapy of hyperlipidemia may predispose to rhabdomyolysis with acute renal failure. Patients using gemfibrozil should be cautioned regarding strenuous exertion, dehydration, and the need for prompt evaluation of myalgias.
Layne
Richard D
RD
School of Medicine, West Virginia University, Morgantown, WV 26506-9160, USA. rlayne@hsc.wvu.edu
Sehbai
Aasim S
AS
Stark
Linda J
LJ
D058186:Acute Kidney Injury / Q000139:chemically induced*; D000328:Adult; D003404:Creatinine / Q000097:blood*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D015248:Gemfibrozil / Q000009:adverse effects*; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications / Q000188:drug therapy*; D006973:Hypertension / Q000150:complications; D000960:Hypolipidemic Agents / Q000009:adverse effects*; D008297:Male; D005082:Physical Exertion; D012206:Rhabdomyolysis / Q000139:chemically induced* / Q000503:physiopathology
D000960:Hypolipidemic Agents; D003404:Creatinine; D015248:Gemfibrozil