Mogyorósi A, Bradley B, Showalter A, Schubert M L
Department of Medicine, Medical College of Virginia/Virginia Commonwealth University, Richmond, Virginia, USA.
J Intern Med. 1999 Dec;246(6):599-602. doi: 10.1046/j.1365-2796.1999.00610.x.
Simvastatin, an inhibitor of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase, is widely used to treat hyperlipidaemia. Although myalgias are recognized adverse effects, clinically significant elevations in serum creatine phosphokinase (CPK) levels are uncommon. We describe a case of rhabdomyolysis and acute renal failure associated with concomitant use of simvastatin and warfarin. Rhabdomyolysis and renal failure occurred 7 days after warfarin (5 mg day-1) was added to a chronic stable dose of simvastatin (20 mg day-1) and resolved abruptly after discontinuation of simvastatin. We recommend careful monitoring when warfarin is given to patients receiving simvastatin.
辛伐他汀是3-羟基-3-甲基戊二酰辅酶A（HMG-CoA）还原酶的抑制剂，广泛用于治疗高脂血症。虽然肌痛是公认的不良反应，但血清肌酸磷酸激酶（CPK）水平出现具有临床意义的升高并不常见。我们描述了1例与辛伐他汀和华法林联合使用相关的横纹肌溶解症和急性肾衰竭病例。在慢性稳定剂量的辛伐他汀（20mg/日）基础上加用华法林（5mg/日）7天后发生横纹肌溶解症和肾衰竭，停用辛伐他汀后症状迅速缓解。我们建议，在给正在接受辛伐他汀治疗的患者使用华法林时应仔细监测。
