title: Mizoribine-induced rhabdomyolysis in a rheumatoid arthritis patient receiving bezafibrate treatment.
abstract: Bezafibrate, one of fibric acid derivatives, is widely used to treat hypertriglyceridemia and diabetic dyslipidemia. Fibric acid derivatives are known to induce rhabdomyolysis as a side effect, especially when given to patients with renal dysfunction. Mizoribine, an imidazole nucleoside, is used as an immunosuppressive agent. Here, we present a case of a patient with rheumatoid arthritis who developed rhabdomyolysis while undergoing treatment with mizoribine concomitantly with bezafibrate. Drug-induced rhabdomyolysis was suspected and bezafibrate and mizoribine were discontinued, and the patient was treated with hydration. The patient's symptoms rapidly disappeared and abnormalities of blood and urine test findings also improved to normal levels within 1 week. When prescribing fibrates to patients with high risk of renal damage, caution should be exercised regarding interactions with other drugs and the potential for inducing rhabdomyolysis.
authors.affiliation: Department of Internal Medicine, Cardiovascular Division, Hyogo College of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Morimoto
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Fujioka
authors.forename: Chikako
authors.initials: C
authors.lastname: Tsutsumi
authors.forename: Miho
authors.initials: M
authors.lastname: Masai
authors.forename: Takahiro
authors.initials: T
authors.lastname: Okumura
authors.forename: Masao
authors.initials: M
authors.lastname: Yuba
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Sakoda
authors.forename: Takeshi
authors.initials: T
authors.lastname: Tsujino
authors.forename: Mitsumasa
authors.initials: M
authors.lastname: Ohyanagi
mesh_terms: D001172:Arthritis, Rheumatoid / Q000188:drug therapy; D001629:Bezafibrate / Q000009:adverse effects*; D004347:Drug Interactions; D005260:Female; D006801:Humans; D000960:Hypolipidemic Agents / Q000009:adverse effects*; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D008875:Middle Aged; D012206:Rhabdomyolysis / Q000139:chemically induced*; D012263:Ribonucleosides / Q000009:adverse effects*
chemical_list: D000960:Hypolipidemic Agents; D007166:Immunosuppressive Agents; D012263:Ribonucleosides; C010052:mizoribine; D001629:Bezafibrate