Department of Medical Pharmacology, Regional Pharmacovigilance Centre, CHU Bordeaux, F-33000, Bordeaux, France.
University of Bordeaux, Bordeaux, France.
Br J Clin Pharmacol. 2018 May;84(5):1057-1063. doi: 10.1111/bcp.13515. Epub 2018 Feb 26.
Following a severe case of rhabdomyolysis in our University Hospital after a co-administration of atorvastatin and fusidic acid, we describe this interaction as this combination is not clearly contraindicated in some countries, particularly for long-term treatment by fusidic acid. All cases of rhabdomyolysis during a co-administration of a statin and fusidic acid were identified in the literature and in the World and Health Organization database, VigiBase . In the literature, 29 cases of rhabdomyolysis were identified; mean age was 66 years, median duration of co-administration before rhabdomyolysis occurrence was 21 days, 28% of cases were fatal. In the VigiBase , 182 cases were retrieved; mean age was 68 years, median duration of co-administration before rhabdomyolysis was 31 days and 24% of cases were fatal. Owing to the high fatality associated with this co-administration and the long duration of treatment before rhabdomyolysis occurrence, fusidic acid should be used if there is no appropriate alternative, as long as statin therapy is interrupted for the duration of fusidic acid therapy, and perhaps a week longer. Rarely will interruption of this sort have adverse consequences for the patient.
在我们大学医院，阿托伐他汀与夫西地酸联合使用后出现严重横纹肌溶解症，我们描述了这种相互作用，因为这种联合用药在某些国家并非明确禁忌，尤其是对于长期使用夫西地酸的情况。在文献和世界卫生组织数据库（VigiBase）中都发现了他汀类药物与夫西地酸联合使用时发生横纹肌溶解症的所有病例。文献中确定了 29 例横纹肌溶解症，平均年龄为 66 岁，横纹肌溶解症发生前联合用药的中位时间为 21 天，28%的病例为致命性。在 VigiBase 中，检索到 182 例，平均年龄为 68 岁，横纹肌溶解症发生前联合用药的中位时间为 31 天，24%的病例为致命性。由于这种联合用药的死亡率很高，而且横纹肌溶解症发生前的治疗时间很长，如果没有合适的替代药物，应使用夫西地酸，只要在夫西地酸治疗期间中断他汀类药物治疗，也许再延长一周。这种中断治疗很少会对患者产生不利后果。
