Simard Chantale, Poirier Paul
Centre de recherche, Hôpital Laval, Université Laval, Sainte-Foy, Quebéc, Canada.
Can J Cardiol. 2006 Feb;22(2):141-4. doi: 10.1016/s0828-282x(06)70253-7.
Two cases of myopathy associated with ezetimibe are reported. In the first case, a woman on ezetimibe monotherapy presented with muscle pain and an elevated concentration of creatine kinase (CK) on two occasions, with ezetimibe 10 mg and with ezetimibe 5 mg after a washout period. The recurrence of muscle pain after washout and the CK increase both supported the hypothesis that ezetimibe alone can be linked to myalgia. In the second case, a man had been treated with atorvastatin, and ezetimibe 10 mg was added to improve his lipid profile. Two months later, the patient complained of muscle pain and a CK increase was noted. The appearance of symptoms when adding ezetimibe to atorvastatin supports a potential pharmacokinetic and/or a pharmacodynamic interaction between these two drugs. These cases suggest that ezetimibe monotherapy as well as ezetimibe associated with the use of a statin may induce myalgia. The mechanism by which ezetimibe could cause muscle pain is not known.
报告了两例与依折麦布相关的肌病病例。在第一例中，一名接受依折麦布单药治疗的女性两次出现肌肉疼痛和肌酸激酶（CK）浓度升高，一次是服用10毫克依折麦布时，另一次是在洗脱期后服用5毫克依折麦布时。洗脱后肌肉疼痛复发以及CK升高均支持依折麦布单独可导致肌痛这一假说。在第二例中，一名男性曾接受阿托伐他汀治疗，后加用10毫克依折麦布以改善其血脂状况。两个月后，患者抱怨肌肉疼痛，且发现CK升高。在阿托伐他汀中加用依折麦布时出现症状，支持了这两种药物之间存在潜在药代动力学和/或药效学相互作用的观点。这些病例表明，依折麦布单药治疗以及与他汀类药物联用均可能诱发肌痛。依折麦布导致肌肉疼痛的机制尚不清楚。
