Rifkin Stephen I
Division of Nephrology, University of South Florida, College of Medicine, Tampa, Florida, USA.
Medscape J Med. 2008;10(11):264. Epub 2008 Nov 19.
Rhabdomyolysis, a syndrome characterized by muscle necrosis with release of toxic intracellular muscle constituents, can be a potentially fatal side effect of medical therapy. Here I report a patient with a 12-year history of simvastatin use who presented with rhabdomyolysis. He had a renal transplant and has been on a stable dose of cyclosporine for the past year. Recent medication changes were the addition of ranolazine, carvedilol, and diltiazem about two months prior to the episode of rhabdomyolysis. Discontinuation of the ranolazine, diltiazem, and simvastatin resulted in prompt resolution of the episode. It is suggested that these medications, acting in concert with cyclosporine, altered the metabolism of simvastatin, causing the episode of rhabdomyolysis. Clinicians should be alert to the possibility of multiple drug interactions causing rhabdomyolysis.
横纹肌溶解症是一种以肌肉坏死并释放有毒细胞内肌肉成分的综合征，可能是药物治疗的潜在致命副作用。在此，我报告一例使用辛伐他汀12年的患者出现横纹肌溶解症。他接受了肾移植，在过去一年中一直服用稳定剂量的环孢素。横纹肌溶解症发作前约两个月最近的用药变化是加用了雷诺嗪、卡维地洛和地尔硫䓬。停用雷诺嗪、地尔硫䓬和辛伐他汀后，该发作迅速缓解。提示这些药物与环孢素协同作用，改变了辛伐他汀的代谢，导致横纹肌溶解症发作。临床医生应警惕多种药物相互作用导致横纹肌溶解症的可能性。
