title: Rhabdomyolysis caused by the moderate CYP3A4 inhibitor fluconazole in a patient on stable atorvastatin therapy: a case report and literature review.
abstract: OBJECTIVE
  Rhabdomyolysis is a severe potential adverse drug reaction of statin therapy. We report a case of rhabdomyolysis due to drug-drug interaction (DDI) between atorvastatin and fluconazole and review the literature.
  
  
  METHODS
  A 70-year-old woman received atorvastatin for hyperlipidaemia without any problem for 4 years. When intravenous fluconazole was added for treating a fungal infection, rhabdomyolysis developed 2 weeks later. Removal of atorvastatin led to the resolution of her rhabdomyolysis.
  
  
  CONCLUSIONS
  Our case demonstrates that in some subjects even a moderate CYP3A4 inhibitor such as fluconazole may lead to rhabdomyolysis in subjects receiving a statin.
authors.affiliation: Department of Pharmacy, National Cheng Kung University Hospital, Tainan, Taiwan.
authors.forename: S-H
authors.initials: SH
authors.lastname: Hsiao
authors.affiliation: Department of Pharmacy, National Cheng Kung University Hospital, Tainan, Taiwan.
authors.forename: H-J
authors.initials: HJ
authors.lastname: Chang
authors.affiliation: Department of Internal Medicine, Medical college and Hospital, National Cheng Kung University, Tainan, Taiwan.
authors.forename: T-H
authors.initials: TH
authors.lastname: Hsieh
authors.affiliation: Department of Pharmacy, National Cheng Kung University Hospital, Tainan, Taiwan.
authors.forename: S-M
authors.initials: SM
authors.lastname: Kao
authors.affiliation: Department of Pharmacy, National Cheng Kung University Hospital, Tainan, Taiwan.
authors.forename: P-Y
authors.initials: PY
authors.lastname: Yeh
authors.affiliation: Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.|College of Medicine, National Cheng Kung University, Tainan, Taiwan.
authors.forename: T-J
authors.initials: TJ
authors.lastname: Wu
mesh_terms: D000368:Aged; D000069059:Atorvastatin / Q000009:adverse effects*; D065692:Cytochrome P-450 CYP3A Inhibitors / Q000009:adverse effects*; D004347:Drug Interactions; D005260:Female; D015725:Fluconazole / Q000009:adverse effects*; D006801:Humans; D012206:Rhabdomyolysis / Q000139:chemically induced*
chemical_list: D065692:Cytochrome P-450 CYP3A Inhibitors; D015725:Fluconazole; D000069059:Atorvastatin
keywords: atorvastatin; drug interaction; fluconazole; rhabdomyolysis