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. 2015:2015:761393.
doi: 10.1155/2015/761393. Epub 2015 Mar 26.

Severe rhabdomyolysis associated with simvastatin and role of ciprofloxacin and amlodipine coadministration

Nicolas De Schryver  1 , Xavier Wittebole  1 , Peter Van den Bergh  2 , Vincent Haufroid  3 , Eric Goffin  4 , Philippe Hantson  5
Affiliations

Severe rhabdomyolysis associated with simvastatin and role of ciprofloxacin and amlodipine coadministration

Nicolas De Schryver et al. Case Rep Nephrol. 2015.

Abstract

Simvastatin is among the most commonly used prescription medications for cholesterol reduction and the most common statin-related adverse drug reaction is skeletal muscle toxicity. Multiple factors have been shown to influence simvastatin-induced myopathy. In addition to age, gender, ethnicity, genetic predisposition, and dose, drug-drug interactions play a major role. This is particularly true for drugs that are extensively metabolized by cytochrome P450 (CYP)3A4. We describe a particularly severe case of rhabdomyolysis after the introduction of ciprofloxacin, a weak CYP3A4 inhibitor, in a patient who previously tolerated the simvastatin-amlodipine combination.

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