title: Rhabdomyolysis resulting from pharmacologic interaction between erlotinib and simvastatin.
abstract: Erlotinib is an epidermal growth factor receptor inhibitor indicated as a second line of therapy for locally advanced and metastatic non-small-cell lung cancer after the failure of 1 previous chemotherpy. Simvastatin belongs to the statin family used to lower blood cholesterol. Drug interaction between erlotinib and statin has not been reported before. Both drugs are major substrates of the CYP3A4 enzyme in the liver. Thus, co-administration of these drugs can increase their serum levels, potentially leading to adverse effects. We report the interaction between erlotinib and simvastatin leading to rhabdomyolysis. Thus, caution is required with increasing usage of both of these drugs.
authors.affiliation: Department of Internal Medicine, Abington Memorial Hospital, Abington, PA, USA. mveeraputhiran@amh.org
authors.forename: Muthu
authors.initials: M
authors.lastname: Veeraputhiran
authors.forename: Mark
authors.initials: M
authors.lastname: Sundermeyer
mesh_terms: D000368:Aged; D017311:Amlodipine / Q000008:administration & dosage; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D000924:Anticholesteremic Agents / Q000009:adverse effects*; D000959:Antihypertensive Agents / Q000008:administration & dosage; D001241:Aspirin / Q000008:administration & dosage; D001262:Atenolol / Q000008:administration & dosage; D001384:Azetidines / Q000008:administration & dosage; D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications / Q000188:drug therapy; D003324:Coronary Artery Disease / Q000150:complications; D004347:Drug Interactions; D000069347:Erlotinib Hydrochloride; D000069438:Ezetimibe; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications / Q000188:drug therapy; D006973:Hypertension / Q000150:complications / Q000188:drug therapy; D008175:Lung Neoplasms / Q000150:complications / Q000188:drug therapy; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy; D047428:Protein Kinase Inhibitors / Q000009:adverse effects*; D011799:Quinazolines / Q000009:adverse effects*; D012206:Rhabdomyolysis / Q000139:chemically induced*; D019821:Simvastatin / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000924:Anticholesteremic Agents; D000959:Antihypertensive Agents; D001384:Azetidines; D047428:Protein Kinase Inhibitors; D011799:Quinazolines; D017311:Amlodipine; D001262:Atenolol; D019821:Simvastatin; D000069347:Erlotinib Hydrochloride; D000069438:Ezetimibe; D001241:Aspirin