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Case Reports
. 2021 Nov 30;13(11):e20035.
doi: 10.7759/cureus.20035. eCollection 2021 Nov.

A Rare Case of Delayed Onset Multi-Drug Interaction Resulting in Rhabdomyolysis in a 66-Year-Old Male

Harmony Osborn  1 , Daniel Grossman  1 , Smriti Kochhar  1 , Anish Kanukuntla  1 , Priyaranjan Kata  1 , Pramil Cheriyath  1
Affiliations
Case Reports

A Rare Case of Delayed Onset Multi-Drug Interaction Resulting in Rhabdomyolysis in a 66-Year-Old Male

Harmony Osborn et al. Cureus. .

Abstract

Drug-drug interactions in medications metabolized by cytochrome P450 enzymes can lead to multi-organ complications. An uncommon but serious potential adverse effect of statins is rhabdomyolysis, most commonly triggered by drug interactions. Rhabdomyolysis presents with markedly elevated creatine kinase levels, dark urine, and often myoglobinuria. The breakdown of the muscles during rhabdomyolysis can be toxic to the kidneys, often precipitating acute kidney injury (AKI) and can also damage the liver, causing transaminitis. This study presents a case of a 66-year-old male with delayed onset complex pharmacological interaction between ticagrelor, rosuvastatin, and amiodarone resulting in rhabdomyolysis, AKI, and transaminitis.

Keywords: acute kidney injury; amiodarone; drug-drug interactions; rhabdomyolysis; rosuvastatin; ticagrelor.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Non-contrast CT coronal view (A), axial view (B) of the abdomen.
Figures 1A and 1B show right (red arrow) and left (white arrow) kidneys with no nephrolithiasis or perinephric fat.
See this image and copyright information in PMC

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