title: Creatine kinase elevation caused by a combination of fluvastatin and telmisartan in a patient heterozygous for the CYP2C9*3 and ABCC2 -24C > T variants: a case report.
abstract: BACKGROUND
  Genetic factors as predictor of the individual outcome of drug therapy is one aim of personalized medicine approaches.
  
  
  METHODS
  We report a drug metabolism based analysis of genetic polymorphisms in a Caucasian patient receiving fluvastatin and telmisartan experiencing myotoxicity (myalgia and moderate creatine kinase elevation).
  
  
  CONCLUSIONS
  The obtained findings suggest that heterocygocity of cytochrome P450 CYP2C9*3 variant in combination with multidrug resistance-associated protein MRP2-24C > T functions as risk factor predisposing to experience drug-drug interaction combing those drugs.
authors.forename: Henriette E
authors.initials: HE
authors.lastname: Meyer zu Schwabedissen
authors.forename: Werner
authors.initials: W
authors.lastname: Siegmund
authors.forename: Heyo K
authors.initials: HK
authors.lastname: Kroemer
authors.affiliation: Institute for Neurorehabilitational Research (InFo), BDH-Clinic, Hessisch Old- endorf, Germany, Teaching Hospital of Hannover Medical School (MHH), Germany. prof.rollnik@bdh-klinik-hessisch-oldendorf.de.
authors.forename: Jens D
authors.initials: JD
authors.lastname: Rollnik
mesh_terms: D000328:Adult; D047228:Angiotensin II Type 1 Receptor Blockers / Q000008:administration & dosage / Q000009:adverse effects; D001483:Base Sequence; D001562:Benzimidazoles / Q000008:administration & dosage / Q000009:adverse effects*; D001565:Benzoates / Q000008:administration & dosage / Q000009:adverse effects*; D003402:Creatine Kinase / Q000097:blood*; D065729:Cytochrome P-450 CYP2C9 / Q000235:genetics*; D017931:DNA Primers; D004359:Drug Therapy, Combination; D005229:Fatty Acids, Monounsaturated / Q000008:administration & dosage / Q000009:adverse effects*; D000077340:Fluvastatin; D006579:Heterozygote; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects; D007211:Indoles / Q000008:administration & dosage / Q000009:adverse effects*; D008297:Male; D000089762:Multidrug Resistance-Associated Protein 2; D027425:ATP-Binding Cassette, Sub-Family C Proteins / Q000235:genetics*; D000077333:Telmisartan
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D001562:Benzimidazoles; D001565:Benzoates; D003402:Creatine Kinase; D065729:Cytochrome P-450 CYP2C9; D017931:DNA Primers; D005229:Fatty Acids, Monounsaturated; D000077340:Fluvastatin; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007211:Indoles; D000089762:Multidrug Resistance-Associated Protein 2; D027425:ATP-Binding Cassette, Sub-Family C Proteins; D000077333:Telmisartan; C000715087:ABCC2 protein, human