Rhabdomyolysis caused by the moderate CYP3A4 inhibitor fluconazole in a patient on stable atorvastatin therapy: a case report and literature review

Summary What is known and 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. Case summary A 70‐year‐old woman received atorvastat...

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Bibliographic Details
Published in:Journal of clinical pharmacy and therapeutics 2016-10, Vol.41 (5), p.575-578
Main Authors: Hsiao, S.‐H., Chang, H.‐J., Hsieh, T.‐H., Kao, S.‐M., Yeh, P.‐Y., Wu, T.‐J.
Format: Article
Language:English
Subjects:
Aged
atorvastatin
Atorvastatin Calcium - adverse effects
Cytochrome P-450 CYP3A Inhibitors - adverse effects
drug interaction
Drug Interactions
Female
fluconazole
Fluconazole - adverse effects
Humans
rhabdomyolysis
Rhabdomyolysis - chemically induced
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Summary:Summary What is known and 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. Case summary 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. What is new and conclusion Our case demonstrates that in some subjects even a moderate CYP3A4 inhibitor such as fluconazole may lead to rhabdomyolysis in subjects receiving a statin. Characteristics of reported cases of rhabdomyolysis associated with drug interaction between statins and fluconazole.
ISSN:0269-4727
1365-2710
DOI:10.1111/jcpt.12425