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Case Reports
. 2008 Oct;25(10):1229-30.
doi: 10.1111/j.1464-5491.2008.02536.x.

Renal failure and rhabdomyolysis associated with sitagliptin and simvastatin use

D P Kao  1 , H E Kohrt, J Kugler
Affiliations
Case Reports

Renal failure and rhabdomyolysis associated with sitagliptin and simvastatin use

D P Kao et al. Diabet Med. 2008 Oct.

Abstract

Background: Sitagliptin is a new oral glucose-lowering medication that acts via the incretin hormone system. The most common side-effects are headache and pharyngitis, and few serious adverse events were observed during clinical trials. Dose adjustment is recommended in renal insufficiency, but long-term safety experience is limited.

Case report: We present a patient with chronic renal insufficiency who developed leg pain, weakness and tenderness after starting treatment with high-dose sitagliptin while on simvastatin. The patient had acute renal failure and rhabdomyolysis that resolved with cessation of sitagliptin, simvastatin, ezetimibe, diuretics and olmesartan. All drugs except sitagliptin, ezetimibe and simvastatin were resumed, and the patient was subsequently started on lovastatin without recurrence of rhabdomyolysis.

Conclusions: High doses of sitagliptin may have worsened this patient's renal failure and precipitated rhabdomyolysis by increasing circulating levels of simvastatin. Given the high likelihood that sitagliptin will be co-administered with statins and renally active medications, further study of long-term safety of sitagliptin in renal sufficiency may be warranted.

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References

    1. Bergman AJ, et al. Effect of renal insufficiency on the pharmacokinetics of sitagliptin, a dipeptidyl peptidase-4 inhibitor. Diabetes Care. 2007;30:1862–1864. - PubMed
    1. Herman GA, et al. Pharmacokinetics and pharmacodynamics of single doses of sitagliptin, an inhibitor of dipeptidyl peptidase-IV in healthy subjects. Clin Pharm Therap. 2005;78:675–688. - PubMed
    1. Pharmacology/Toxicology Review and Evaluation - NDA 21-995 . Center for Drug Evaluation and Research, Food and Drug Administration. Washington, DC: 2006. http://www.accessdata.fda.gov/scripts/cder/drugsatfda (accessed 4/30/2008)
    1. Kramer MS, et al. An algorithm for the operational assessment of adverse drug reactions: I. Background, Description, and Instructions for Use. JAMA. 1979;242:623–632. - PubMed
    1. Center for Drug Evaluation and Research Adverse Event Reporting System. Center for Drug Evaluation and Research Website. http://www.fda.gov/cder/aers (accessed October 25, 2007)

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