title: When Nutraceuticals Reinforce Drugs Side Effects: A Case Report.
abstract: BACKGROUND
  Nutraceutical is a term applied for a plethora of products ranging from isolated nutrients, herbal products to dietary supplements and recently, the interest for a nutraceutical approach to lipid and metabolic disorders is growing. Patients with metabolic conditions seem to appreciate a therapeutic management that does not involve drug treatment, particularly for the side effects due to statins, a class of drug used for lipid disorders. Statins directly induce skeletal muscle injury and in the elderly patients, under polytherapy treatments, this risk relies to an increase in adverse drug reactions due to drug interactions.
  
  
  METHODS
  Herein we report a 70-year-old woman under polytherapy who developed rhabdomyolysis after starting the administration of a dietary supplement containing monacolin K. Using the Drug Interaction Probability Scale, we postulated that rhabdomyolysis was possibly related to a drug interaction between sertraline, rosuvastatin and monacolin K. These treatments were discontinued leading to a remission of both clinical symptoms and biochemical parameters.
  
  
  CONCLUSIONS
  This case report highlights how pharmacological treatment must be periodically reassessed, since elderly people could take drugs by themselves when they donot need.
authors.forename: Roberto
authors.initials: R
authors.lastname: Russo
authors.affiliation: Department of Health Science, School of Medicine, University of Catanzaro, Clinical Pharmacology Unit, Mater Domini University Hospital, Viale Europa - Germaneto 88100 Catanzaro, Italy. gallelli@unicz.it.
authors.forename: Luca
authors.initials: L
authors.lastname: Gallelli
authors.forename: Roberto
authors.initials: R
authors.lastname: Cannataro
authors.forename: Mariarita
authors.initials: M
authors.lastname: Perri
authors.forename: Antonio
authors.initials: A
authors.lastname: Calignano
authors.forename: Rita
authors.initials: R
authors.lastname: Citraro
authors.forename: Emilio
authors.initials: E
authors.lastname: Russo
authors.forename: Pietro
authors.initials: P
authors.lastname: Gareri
authors.forename: Andrea
authors.initials: A
authors.lastname: Corsonello
authors.forename: Giovambattista De
authors.initials: GD
authors.lastname: Sarro
mesh_terms: D000368:Aged; D019587:Dietary Supplements / Q000009:adverse effects*; D064420:Drug-Related Side Effects and Adverse Reactions / Q000175:diagnosis / Q000378:metabolism; D005260:Female; D018565:Food-Drug Interactions / Q000502:physiology; D006801:Humans; D012206:Rhabdomyolysis / Q000139:chemically induced* / Q000175:diagnosis* / Q000378:metabolism; D000068718:Rosuvastatin Calcium / Q000009:adverse effects* / Q000378:metabolism
chemical_list: D000068718:Rosuvastatin Calcium