Rhabdomyolysis after addition of digitoxin to chronic simvastatin and amiodarone therapy.
Rhabdomyolysis is a well known side effect of statin therapy. Several drugs may increase its risk by drug-drug interactions. In particular, patients with heart disease receive more and more different compounds to cope with all the pathomechanisms involved and may therefore be of high risk for side effects. We report a case of rhabdomyolysis in a patient with heart failure on a multi-drug regimen caused by a drug interaction between chronic statin therapy (simvastatin), amiodarone and newly administrated digitoxin. The patient recovered fully after cessation of simvastatin therapy, the other drugs were given continuously. Potential mechanisms of this event are discussed. Most interesting in this case is that rhabdomyolysis occurred only after starting digitoxin after long-term therapy with the statin.
Nägele
H
H
St. Adolfstift Medical Clinic, Reinbek, Germany. herbert_naegele@yahoo.de
Behrens
S
S
Hashagen
S
S
Azizi
M
M
D000638:Amiodarone / Q000009:adverse effects*; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects*; D000924:Anticholesteremic Agents / Q000009:adverse effects*; D004074:Digitoxin / Q000009:adverse effects*; D004347:Drug Interactions; D006333:Heart Failure / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D012206:Rhabdomyolysis / Q000139:chemically induced*; D012307:Risk Factors; D019821:Simvastatin / Q000009:adverse effects*
D000889:Anti-Arrhythmia Agents; D000924:Anticholesteremic Agents; D019821:Simvastatin; D004074:Digitoxin; D000638:Amiodarone