title: Acute rhabdomyolysis caused by combination therapy with atorvastatin and warfarin.
abstract: Atorvastatin and warfarin are commonly prescribed in combination. Acute rhabdomyolysis is a rare but recognized side effect of atorvastatin occurring within a few weeks of initiation. This article presents a case of a 69-year-old man, on stable atorvastatin therapy, who developed acute rhabdomyolysis following initiation of warfarin. Rising international normalized ratio is a well-recognized feature of interaction between warfarin and various statins (fluvastatin, lovastatin and simva-statin). There has only been one previous similar case of acute rhabdomyolysis following the commencement of warfarin, reported in a patient on stable simvastatin therapy. To the authors' knowledge, no similar case has been reported with atorvastatin.
authors.affiliation: Elise Bertman Diabetes Centre, Norfolk and Norwich University Hospital.
authors.forename: J W
authors.initials: JW
authors.lastname: Mackay
authors.forename: M E
authors.initials: ME
authors.lastname: Fenech
authors.forename: K S
authors.initials: KS
authors.lastname: Myint
mesh_terms: D000208:Acute Disease; D000368:Aged; D000924:Anticholesteremic Agents / Q000009:adverse effects* / Q000493:pharmacokinetics / Q000627:therapeutic use; D000925:Anticoagulants / Q000009:adverse effects* / Q000493:pharmacokinetics / Q000627:therapeutic use; D000069059:Atorvastatin; D001281:Atrial Fibrillation / Q000188:drug therapy; D004347:Drug Interactions; D006538:Heptanoic Acids / Q000009:adverse effects* / Q000493:pharmacokinetics / Q000627:therapeutic use; D006801:Humans; D006937:Hypercholesterolemia / Q000188:drug therapy; D008297:Male; D011758:Pyrroles / Q000009:adverse effects* / Q000493:pharmacokinetics / Q000627:therapeutic use; D012206:Rhabdomyolysis / Q000139:chemically induced* / Q000175:diagnosis; D014859:Warfarin / Q000009:adverse effects* / Q000493:pharmacokinetics / Q000627:therapeutic use
chemical_list: D000924:Anticholesteremic Agents; D000925:Anticoagulants; D006538:Heptanoic Acids; D011758:Pyrroles; D014859:Warfarin; D000069059:Atorvastatin