Korean J Nephrol.  2004 Sep;23(5):836-839.

Rhabdomyolysis in a Cyclosporine-treated Renal Transplant Recipient Who Received Atorvastatin as Replacement for Fluvastatin

Affiliations
  • 1Department of Internal Medicine, Soon Chun Hyang University Cheonan Hospital, Cheonan, Korea. eylee@sch.ac.kr

Abstract

Statin-induced rhabdomyolysis is a frequent complication in renal transplant recipients receiving cyclosporine, but incidences are different between different types of statins. Statins have different pharmacokinetic properties. Atorvsatatin, simvastatin, lovastatin, and cerivastatin are all metabolized by the cytochrome P450 isoenzyme 3A4 and co-administration of cyclosporine which may inhibit cytochrome P450 isoenzyme 3A4, increases statin levels and therefore increases the risk of rhabdomyolysis. Fluvastatin is metabolized by cytochrome P450 isoenzyme 2C9 and no clinically significant interactions with cyclosporine have been reported. Atorvastatin with co-administration of cyclosporine in renal transplant patients may induce drug interactions, therefore we recommend the routine monitoring of muscle enzymes, in these cases. Here, we reported a case of rhabdomyolysis in a patient who received atorvastatin and cyclosporine with the review of the literature.

Keyword

Rhabdomyolysis; Atorvastatin; Cyclosporine; Fluvastatin

MeSH Terms

Cyclosporine
Cytochrome P-450 Enzyme System
Drug Interactions
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Incidence
Lovastatin
Rhabdomyolysis*
Simvastatin
Transplantation*
Atorvastatin Calcium
Cyclosporine
Cytochrome P-450 Enzyme System
Lovastatin
Simvastatin
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