Statin-induced rhabdomyolysis from azithromycin interaction in a patient with heterozygous SLCO1B1 polymorphism.
J Clin Pharm Ther
; 46(3): 853-855, 2021 Jun.
Article
em En
| MEDLINE
| ID: mdl-33277702
ABSTRACT
WHAT IS KNOWN AND OBJECTIVE:
Unlike other macrolide antibiotics, azithromycin is considered safe to co-prescribe with simvastatin. We aim to elucidate the mechanism of a rare azithromycin-simvastatin interaction. CASE DESCRIPTION We report a case of simvastatin-induced rhabdomyolysis caused by an azithromycin drug interaction in a patient with heterozygous SLCO1B1 loss-of-function polymorphism. We propose a dual-hit mechanism for this drug-drug-genome interaction. Azithromycin mildly inhibits simvastatin's CYP 3A4 hepatic metabolism, and the SLCO1B1 polymorphism reduces simvastatin hepatic uptake. The combination increases simvastatin serum concentrations significantly, inducing rhabdomyolysis. WHAT IS NEW ANDCONCLUSION:
Patients with statin-induced myopathy associated with non-classic CYP inhibitors should be considered for genetic testing and alternative statins with less risk of future interactions.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Rabdomiólise
/
Azitromicina
/
Inibidores de Hidroximetilglutaril-CoA Redutases
/
Transportador 1 de Ânion Orgânico Específico do Fígado
/
Antibacterianos
/
Hipolipemiantes
Limite:
Aged
/
Humans
/
Male
Idioma:
En
Revista:
J Clin Pharm Ther
Assunto da revista:
FARMACIA
/
TERAPEUTICA
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Estados Unidos