Wang Dawei, Wang Yanqiu
Department of Neurosurgery, the second affiliated hospital of Bengbu medical college, Bengbu Department of Endocrinology, Benxi Central Hospital, Liaoning, People's Republic of China.
Medicine (Baltimore). 2018 Apr;97(14):e0318. doi: 10.1097/MD.0000000000010318.
Fenofibrate is a fibric acid derivative indicated for use in hypertriglyceridemia and mixed dyslipidemia treatment among adults. Rhabdomyolysis is a syndrome characterized by muscle necrosis and the release of intracellular muscle contents into the systemic circulation, which is the most serious and fatal side effect of fenofibrate. The objective of this paper is to discuss fatal side effect of fenofibrate and keep safe medication.
A patient with hypothyroidism who presented with rhabdomyolysis during fenofibrate monotherapy for hypertriglyceridemia was reported.
Fenofibrate Monotherapy Induced Rhabdomyolysis.
Fenofibrate was stopped. Adequate fluid resuscitation, mannitol diuresis, myocardium protection, hepatoprotection and urine alkalinization with sodium bicarbonate were performed.
Blood tests were normal and the patient was good and discharged 2 weeks later.
13 cases associated with fenofibrate monotherapy-induced rhabdomyolysis were reviewed, which had been published in the English literature. The severity of fenofibrate muscle toxicity may be the result of the combination of two rhabdomyolysis enhancers, such as hypothyroidism and female gender. To avoid it, strict clinical and laboratory monitoring should be maintained, particularly hypothyroidism. Patients should be informed of possible potentially irreversible effects after taking fibrates.
非诺贝特是一种纤维酸衍生物，适用于治疗成人高甘油三酯血症和混合性血脂异常。横纹肌溶解症是一种以肌肉坏死和细胞内肌肉成分释放进入体循环为特征的综合征，是非诺贝特最严重和致命的副作用。本文旨在探讨非诺贝特的致命副作用并确保安全用药。
报告了一名甲状腺功能减退患者，在接受非诺贝特单药治疗高甘油三酯血症期间出现横纹肌溶解症。
非诺贝特单药治疗引起的横纹肌溶解症。
停用非诺贝特。进行了充分的液体复苏、甘露醇利尿、心肌保护、肝脏保护以及用碳酸氢钠碱化尿液。
血液检查正常，患者情况良好，2周后出院。
回顾了英文文献中发表的13例与非诺贝特单药治疗引起的横纹肌溶解症相关的病例。非诺贝特肌肉毒性的严重程度可能是两种横纹肌溶解症增强因素（如甲状腺功能减退和女性性别）共同作用的结果。为避免这种情况，应进行严格的临床和实验室监测，尤其是甲状腺功能减退方面。应告知患者服用贝特类药物后可能出现的潜在不可逆影响。
