title: Severe rhabdomyolysis associated with simvastatin and role of ciprofloxacin and amlodipine coadministration.
abstract: Simvastatin is among the most commonly used prescription medications for cholesterol reduction and the most common statin-related adverse drug reaction is skeletal muscle toxicity. Multiple factors have been shown to influence simvastatin-induced myopathy. In addition to age, gender, ethnicity, genetic predisposition, and dose, drug-drug interactions play a major role. This is particularly true for drugs that are extensively metabolized by cytochrome P450 (CYP)3A4. We describe a particularly severe case of rhabdomyolysis after the introduction of ciprofloxacin, a weak CYP3A4 inhibitor, in a patient who previously tolerated the simvastatin-amlodipine combination.
authors.affiliation: Department of Intensive Care, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, 1200 Brussels, Belgium.
authors.forename: Nicolas
authors.initials: N
authors.lastname: De Schryver
authors.affiliation: Department of Intensive Care, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, 1200 Brussels, Belgium.
authors.forename: Xavier
authors.initials: X
authors.lastname: Wittebole
authors.affiliation: Centre de Référence Neuromusculaire, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, 1200 Brussels, Belgium.
authors.forename: Peter
authors.initials: P
authors.lastname: Van den Bergh
authors.affiliation: Louvain Centre for Toxicology and Applied Pharmacology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, 1200 Brussels, Belgium.
authors.forename: Vincent
authors.initials: V
authors.lastname: Haufroid
authors.affiliation: Department of Nephrology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, 1200 Brussels, Belgium.
authors.forename: Eric
authors.initials: E
authors.lastname: Goffin
authors.affiliation: Department of Intensive Care, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, 1200 Brussels, Belgium ; Louvain Centre for Toxicology and Applied Pharmacology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, 1200 Brussels, Belgium.
authors.forename: Philippe
authors.initials: P
authors.lastname: Hantson